Background:The trajectory of intrinsic capacity(IC)among the older population is characterized by its diversity and is predictive of adverse health outcomes such as disability,nursing home admission,decline in quality...Background:The trajectory of intrinsic capacity(IC)among the older population is characterized by its diversity and is predictive of adverse health outcomes such as disability,nursing home admission,decline in quality of life,and mortality.Gaining an understanding of the trajectory of IC and the factors that influence it is of paramount importance for fostering healthy aging.This research is focused on exploring the trajectory of IC among older adults in China and examining the factors that influence it.Methods:This observational longitudinal cohort study leveraged data from the China Health and Retirement Longitudinal Study(CHARLS),which was conducted in the years 2011,2013,and 2015.For the purpose of this analysis,a total of 2,233 participants who were aged 60 and over were included.A Growth Mixture Model(GMM)was utilized to define trajectory categories for IC.Influential factors were ascertained based on the health ecology model,and binary logistic regression analysis was utilized to investigate the factors linked with the different trajectory categories.Results:Two distinct trajectory classes of IC were identified:Class 1,the normal-stable group,encompassed 90.4%of the elderly population,while Class 2,the declining group,made up 9.6%.Advanced age and a history of stroke were found to be significantly associated with Class 2.High scores in activities of daily living(ADL),employment status,receiving primary or junior high school education,and residence in the East or Central regions of China were significantly linked with Class 1.Conclusion:The trajectory of IC among older Chinese adults is marked by its heterogeneity.Advanced age and a history of stroke are significant risk factors for a declining IC trajectory,while higher ADL scores,being employed,receiving primary or junior high school education,and residing in the East or Central regions of China are protective factors associated with a stable IC trajectory.Healthcare institutions must closely monitor IC levels and understand these trajectory patterns to implement personalized and targeted interventions promptly to maintain IC at a healthy level and advocate for healthy aging.展开更多
Understanding water chemistry in karst regions is crucial for improving global water resource management and deepening our knowledge of the biogeochemical cycles shaping these sensitive environments.Despite advance-me...Understanding water chemistry in karst regions is crucial for improving global water resource management and deepening our knowledge of the biogeochemical cycles shaping these sensitive environments.Despite advance-ments in karst hydrology,significant gaps remain in long-term trends,underlying processes,and quantitative effects of environmental changes.This is especially true in areas like the Wujiang River(WJ)in China,where human activities such as reservoir construction and land use/cover changes have accelerated hydrochemical changes.We combined recent and historical monitoring data to provide a detailed analysis of the spatial and temporal characteristics,evolution,and controlling factors of major ions in WJ.These findings are important for local water management and contribute to global efforts to manage similar karst systems facing human-induced pressures.Our research shows clear seasonal differences in solute concentrations,with higher levels during the dry season.WJ’s water is rich in calcium,with Ca-HCO_(3) ion pairs being the most common.Reservoir monitor-ing stations show much higher levels of NO_(3)^(−)and SO_(4)^(2−)compared to river-type stations,likely due to longer hydraulic retention time and increased acid deposition.The study confirms the significant role of pH and water temperature in rock weathering processes.Land use/cover changes were identified as the primary drivers of solute variations(46.37%),followed by lithology(13.92%)and temperature(8.35%).Over the past two decades,in-tense carbonate weathering has been observed,especially during wet seasons.Among karstic provinces,Guizhou Province stands out with the highest ion concentrations,indicative of its extensive karst coverage and heightened weathering processes.展开更多
This paper provides a systematic review of the histochemical localization,content characteristics,and influencing factors of saponins in Pseudostellaria heterophylla based on an extensive literature survey.It provides...This paper provides a systematic review of the histochemical localization,content characteristics,and influencing factors of saponins in Pseudostellaria heterophylla based on an extensive literature survey.It provides an in-depth analysis and summary of the effects of biological factors,environmental conditions,agronomic practices,processing methods,and continuous cropping obstacles on the synthesis of P.heterophylla saponins,as well as their underlying mechanisms.Based on identified gaps in the current literature,future research directions and prospects are proposed.The findings of this review offer valuable insights for advancing the understanding of the saponin biosynthesis mechanisms in P.heterophylla and for enhancing its quality.展开更多
BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different ...BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different factors.AIM To investigate the key determinants of aseptic loosening,we performed a systematic review and meta-analysis.METHODS A comprehensive search of PubMed,Web of Science,EMBASE,and the Cochrane Library was conducted,encompassing studies from database inception to January 1,2025.Meta-analyses were performed to evaluate factors associated with aseptic loosening following pTHA.Inclusion and exclusion criteria were systematically applied at each stage to ensure methodological transparency and reproducibility.Study quality was assessed using standardized categories.Pooled odds ratio(OR)with corresponding 95%confidence interval were calculated with random-or fixed-effects models to generate reliability estimates,and study heterogeneity was visualized using forest plots.Ten factors,categorized into patient-,surgeon-,and device-related domains,were reviewed and meta-analyzed.Funnel plot analysis demonstrated a relatively symmetrical distribution,suggesting minimal publication bias.RESULTS A meta-analysis of 20 studies(520789 participants)found a pooled prevalence of 1.96%.Significant risk factors for aseptic loosening after pTHA included elevated body mass index(OR=1.116,P<0.001),higher Charlson comorbidity index(OR=1.378,P<0.001),prosthesis-related factors(OR=1.497,P<0.001),and adverse lifestyles(OR=2.198,P=0.037).Protective factors were non-white race(OR=0.445,P<0.001)and favorable genetics(OR=0.723,P<0.001).Male sex increased risk(OR=1.232,P=0.016),while age and anatomy were not significant.Surgical expertise showed a slight protective effect(OR=1.048,P<0.001).A comprehensive understanding of the modifiable and non-modifiable factors contributing to aseptic loosening after pTHA requires consideration of patient-related factors,surgical expertise,and prosthesis characteristics.CONCLUSION The identification of these factors is critical for risk mitigation.High-risk patients should receive targeted counseling regarding individualized profiles.Further studies are warranted to establish clearer causal relationships and identify additional contributing factors.展开更多
BACKGROUND Esophageal cancer is highly malignant and frequently metastasizes to bones.Concomitant depression worsens prognosis;however,its incidence and determinants in this specific population remain poorly defined.A...BACKGROUND Esophageal cancer is highly malignant and frequently metastasizes to bones.Concomitant depression worsens prognosis;however,its incidence and determinants in this specific population remain poorly defined.AIM To determine the incidence of depression and its independent risk factors in patients with esophageal cancer and bone metastasis.METHODS A total of 100 consecutive eligible patients admitted between March 2022 and March 2025 were recruited.Depression was assessed with the Beck Depression Inventory-II;scores>4 defined the depression group(n=42)and scores≤4 the non-depression group(n=58).Demographic,clinical,and laboratory variables were compared between the groups.Multivariate logistic regression was used to identify independent risk factors.RESULTS Depression prevalence was 42.0%(42/100).Univariate analysis demonstrated significant differences in monthly per-capita household income,education level,social support,sleep disorders,and serum high-sensitivity C-reactive protein(all P<0.05);no differences were observed in sex,age,tumor characteristics,or other laboratory indices(all P>0.05).Multivariable analysis revealed the following independent risk factors for depression:Low income[odds ratio(OR)=2.66,95%confidence interval(CI):1.17-6.03],low education(OR=2.46,95%CI:1.08-5.61),low social support(OR=5.10,95%CI:1.81-14.39),sleep disorders(OR=2.79,95%CI:1.23-6.35),and elevated high-sensitivity C-reactive protein(OR=1.31 per unit increase,95%CI:1.18-1.46).CONCLUSION Depression is common among patients with esophageal cancer and bone metastasis.Low socioeconomic status,limited education,insufficient social support,sleep disturbances,and systemic inflammation were independent predictors.Interventions that address these modifiable factors may reduce depression risk in this population.展开更多
Analyzing the driving behavior of autonomous vehicles(AV)in mixed traffic conditions at urban intersections has become increasingly important for improving intersection design,providing infrastructure-based guidance i...Analyzing the driving behavior of autonomous vehicles(AV)in mixed traffic conditions at urban intersections has become increasingly important for improving intersection design,providing infrastructure-based guidance information,and developing capability-enhanced AV perception systems.This study investigated the contributing factors affecting AV driving behavior using theWaymo Open Dataset.Binarized autonomous driving stability metrics,derived via a kernel density estimation,served as the target variables for a random forest classification model.The model’s input variables included 15 factors divided into four types:intersection-related,surrounding object-related,road infrastructure-related,and time-of-day-related types.The random forest classification model was employed to identify the key factors affecting autonomous driving behavior.In addition,the identified factors were further ranked based on feature importance.SHAP analysis was utilized to enhance model interpretability by quantifying the contribution of each factor and identifying their directional impacts.The type of intersection factor was found to have an importance of 0.243 and was the most influential factor on autonomous driving behavior.On average,intersection-related factors had an importance of 0.196,which is approximately a 31.1%margin over the average importance of surrounding object-related factors.Additionally,the surrounding object-related factors that were collected through sensors on the autonomous vehicle had a high degree of feature importance,especially with the number of pedestrians having the highest importance(0.107)of the types of objects.The correlation between these findings can contribute to the development of various treatments to improvemore harmonized AVs’maneuvering with other road users and facilities in urban mixed traffic environments.展开更多
Objective:Leucine-rich alpha-2 glycoprotein 1(Lrg1)could regulate diverse cells in cerebral ischemiareperfusion.Our study seeks to uncover Lrg1’s impact on endothelial cell heterogeneity via differentiation pathways ...Objective:Leucine-rich alpha-2 glycoprotein 1(Lrg1)could regulate diverse cells in cerebral ischemiareperfusion.Our study seeks to uncover Lrg1’s impact on endothelial cell heterogeneity via differentiation pathways and transcription factors.Method:The CSOmap model measured cell-to-brain-center distances using single-cell RNA sequencing(scRNA-seq)data in middle cerebral artery occlusion reperfusion(MCAO/R).Monocle2 mapped endothelial differentiation paths.Gene set enrichment analysis(GSEA)analyzed endothelial subcluster variations.Database searches revealed a zinc finger MIZ-type containing 1 protein-frizzled 3(Zmiz1-Fzd3)promoter interaction.Endothelial cells were transfected with a Fzd3 promoter-luciferase plasmid.Polymerase chain reaction(PCR)and western blotting assessed MCAO/R or Zmiz1 overexpression effects on Fzd3-related mRNA and proteins.A retroviral vector carrying Zmiz1 was injected into the brains of mice to study its effect on Fzd3.Result:Lrg1−/−mice exhibited elevated cell adhesion proteins and decreased microvascular leakage after MCAO/R.CSOmap showed widened astrocyte spacing in thesemice.RSS revealed Zmiz1 overexpression inMCAO/R+Lrg1−/−mice.MCAO/R and pcDNA3-Zmiz1 transfection both enhanced luciferase activity with Fzd3,indicating Zmiz1 binding to Fzd3.Retroviral Zmiz1 injection or knockdown disrupted ischemic brain tight junctions,highlighting Zmiz1’s key role in blood-brain barrier protection,likely through Fzd3 pathway modulation.Conclusion:The findings indicate Lrg1 knockout induces endothelial differentiation by activating Zmiz1,which is crucial for maintaining blood-brain barrier function,possibly via modulating the Fzd3 pathway.展开更多
The endpoint carbon content in the converter is critical for the quality of steel products,and accurately predicting this parameter is an effective way to reduce alloy consumption and improve smelting efficiency.Howev...The endpoint carbon content in the converter is critical for the quality of steel products,and accurately predicting this parameter is an effective way to reduce alloy consumption and improve smelting efficiency.However,most scholars currently focus on modifying methods to enhance model accuracy,while overlooking the extent to which input parameters influence accuracy.To address this issue,in this study,a prediction model for the endpoint carbon content in the converter was developed using factor analysis(FA)and support vector machine(SVM)optimized by improved particle swarm optimization(IPSO).Analysis of the factors influencing the endpoint carbon content during the converter smelting process led to the identification of 21 input parameters.Subsequently,FA was used to reduce the dimensionality of the data and applied to the prediction model.The results demonstrate that the performance of the FA-IPSO-SVM model surpasses several existing methods,such as twin support vector regression and support vector machine.The model achieves hit rates of 89.59%,96.21%,and 98.74%within error ranges of±0.01%,±0.015%,and±0.02%,respectively.Finally,based on the prediction results obtained by sequentially removing input parameters,the parameters were classified into high influence(5%-7%),medium influence(2%-5%),and low influence(0-2%)categories according to their varying degrees of impact on prediction accuracy.This classi-fication provides a reference for selecting input parameters in future prediction models for endpoint carbon content.展开更多
The study aims to determine the validity and reliability of the Wechsler Preschool and Primary Scale of Intelligence–Third Edition(WPPSI-III)scores in a sample of kindergarten and lower primary pupils from Khartoum S...The study aims to determine the validity and reliability of the Wechsler Preschool and Primary Scale of Intelligence–Third Edition(WPPSI-III)scores in a sample of kindergarten and lower primary pupils from Khartoum State,Sudan.It also aims to examine whether test’s factor structure in this sample replicated that of the original WPPSI-III.The study sample consisted of 384 kindergarten and primary school children in Khartoum State(females=50%mean age=4.14,SD=1.37),selected using stratified random sampling across its seven localities:Khartoum,Jebel Awliya,Khartoum Bahri,East Nile,Omdurman,Ombada,Karari.For concurrent validation,the children additionally completed the Goodenough Draw-a-Man Test,and the Colored Progressive Matrices.WPPSI-III scores demonstrated high internal consistency across the subtest items.Confirmatory factor analysis indicators for total,verbal,and performance intelligence were all excellent.The scale also showed weak to strong score stability ranging from 0.25(weak)to 0.88(strong)based on the Spearman-Brown equation,0.25 to 0.75 based on the Guttman split-half method.The Cronbach’s alpha coefficient scores ranged from 0.54 to 0.93.The WPPSI-III and Goodenough Draw-a-Man Test scores concurrent validity scores were poor(0.05)to modest(0.31),and while those with the Colored Progressive Matrices test were poor(r=0.04–0.18).Thesefindings provide evidence to suggest that the WPPSI-III is appropriate for research use with kindergarten and lower primary school students in Khartoum State,Sudan.展开更多
Under the National Innovation-Driven Development Strategy,establishing a scientifically sound evaluation system for normal university students’innovation and entrepreneurship capabilities serves as a crucial foundati...Under the National Innovation-Driven Development Strategy,establishing a scientifically sound evaluation system for normal university students’innovation and entrepreneurship capabilities serves as a crucial foundation for optimizing innovation education models and enhancing teacher candidates’comprehensive competencies.Based on existing indicator frameworks,we designed a questionnaire and applied exploratory factor analysis(EFA)to screen indicators,reduce dimensionality,and analyze weighting.This process identified key metrics for evaluating pedagogical students’innovation capacities,ultimately constructing a targeted assessment system for normal university students.The study provides theoretical support for cultivating teacher trainees’innovative capabilities while contributing to the national innovation strategy implementation.展开更多
BACKGROUND Dental implants are widely used to replace missing teeth.Currently,clinicians assess osseointegration success by measuring the implant’s stability within the bone and monitoring the marginal tissue height....BACKGROUND Dental implants are widely used to replace missing teeth.Currently,clinicians assess osseointegration success by measuring the implant’s stability within the bone and monitoring the marginal tissue height.Diabetes,especially type 2 diabetes mellitus(T2DM),has been reported to impair implant healing,drastically reducing implant success rates.AIM To analyze the high-risk factors for inflammatory response and prognosis after dental implantation in patients with T2DM,and provide strong evidence for reducing the incidence of postimplant peri-implantitis(PI).METHODS We performed a retrospective review of 146 patients with T2DM who had dental implants placed at Tianjin Fifth Central Hospital,between September 2021 and September 2023,which was regarded as the observation group.Moreover,60 ageand gender-matched individuals with normal blood glucose levels served as the control group.The general information,postoperative periodontal indices,and levels of inflammatory factors were comprehensively analyzed and compared.Furthermore,the incidence of postimplant PI was counted,and multivariate logistic regression was used to identify the determinants of postimplant PI.RESULTS In terms of the periodontal indices,the probing depth,modified sulcus bleeding index,and marginal bone loss in the observation cohorts began to increase significantly at 6 months and 3 months,respectively,after the completion of dental implant restoration.The T2DM cases demonstrated significantly elevated counts of leukocytes,lymphocytes,and neutrophils compared to the controls at 24 hours postoperatively.Moreover,the TNF-α,IL-1β,and IL-6 concentrations started to increase significantly in the gingival crevicular fluid 3 months after the completion of dental implant restoration in both cohorts,with the observation group exhibiting higher levels than the controls at each time point.63 out of the 146 cases developed PI.Multivariate logistic regression analysis indicated that high glycosylated hemoglobin levels,smoking,daily tooth-brushing frequency of less than once,and the anterior tooth as the implant site independently contributed to postimplant PI in T2DM cases,while a tooth-brushing duration of≥3 minutes was a protective factor.CONCLUSION Patients with T2DM are at risk of developing PI following dental implantation.Clinically,it is necessary to enhance the identification of risk factors for postimplant PI,improve risk prediction,prevention,and control,and formulate targeted intervention countermeasures to reduce the occurrence of postimplant PI.展开更多
BACKGROUND Cardiovascular(CV)complications are common in intensive care unit(ICU)patients after gastrointestinal surgery and are associated with increased mortality and prolonged hospital stay.The optimization of post...BACKGROUND Cardiovascular(CV)complications are common in intensive care unit(ICU)patients after gastrointestinal surgery and are associated with increased mortality and prolonged hospital stay.The optimization of postoperative nursing interventions,particularly pain management,is crucial for reducing such complications.AIM To investigate the effects of enhanced recovery nursing on CV complications after gastrointestinal surgery in ICU patients and associated risk factors.METHODS A retrospective analysis was conducted on 78 adult patients who underwent gastrointestinal surgery in the ICU of our hospital between February 2023 and September 2024.Among them,40 patients received standard care(control group),while 38 received enhanced recovery nursing(observation group).We compared the incidence of CV complications and nursing satisfaction between the two groups.Patients were divided into CV complication and non-complication groups based on complication occurrence,and logistic regression analysis was used to identify risk factors.RESULTS In the control and observation groups,the incidence of CV complications was 30.0%(12/40)and 18.4%(7/38),with a nursing satisfaction rate of 70.0%(28/40)and 92.1%(35/38),respectively.The postoperative pain score at 14 days was significantly lower in the observation group(0.27±0.15)compared to the control group(1.65±0.37),with all differences being statistically significant(P<0.05).Univariate analysis indicated significant differences in age,body mass index,hypertension,diabetes,smoking history,history of heart failure,and previous myocardial infarction(P<0.05).Multivariate logistic regression identified heart failure history,previous myocardial infarction,age,hypertension,and diabetes as independent risk factors,with odds ratios of 1.195,1.528,1.062,1.836,and 1.942,respectively(all P<0.05).CONCLUSION Implementing enhanced recovery nursing for ICU patients after gastrointestinal surgery is beneficial in reducing the incidence of CV complications and improving nursing satisfaction.展开更多
BACKGROUND Bile leakage is a common complication following laparoscopic common bile duct exploration(LCBDE)with primary duct closure(PDC).Identifying and analyzing the risk factors associated with bile leakage is cruc...BACKGROUND Bile leakage is a common complication following laparoscopic common bile duct exploration(LCBDE)with primary duct closure(PDC).Identifying and analyzing the risk factors associated with bile leakage is crucial for improving surgical outcomes.AIM To explore the value analysis of common risk factors for bile leakage after LCBDE and PDC,with a focus on strict adherence to indications.METHODS Clinical data of 106 cases undergoing LCBDE+PDC in the Hepatobiliary and Pancreatic Surgery Department(Division 1)of Chuzhou First People’s Hospital from April 2019 to March 2024 were collected.Retrospective and multiple factor regression analysis were conducted on common risk factors for bile leakage.The change in surgical time was analyzed using the cumulative summation(CUSUM)method,and the minimum number of cases required to complete the learning curve for PDC was obtained based on the proposed fitting curve by identifying the CUSUM maximum value.RESULTS Multifactor logistic regression analysis showed that fibrinous inflammation and direct bilirubin/indirect bilirubin were significant independent high-risk factors for postoperative bile leakage(P<0.05).The time to drain removal and length of hospital stay in cases without bile leakage were significantly shorter than in cases with bile leakage(P<0.05),with statistical significance.The CUSUM method indicated that a minimum of 51 cases were required for the surgeon to complete the learning curve(P=0.023).CONCLUSION With a good assessment of duodenal papilla sphincter function,unobstructed bile-pancreatic duct convergence,exact stone clearance,and sufficient surgical experience to complete the learning curve,PDC remains the preferred method for bile duct closure and is worthy of clinical promotion.展开更多
BACKGROUND The development of prostate cancer(PC)frequently intensifies negative emotional states,such as anxiety and depression,which compromise the effectiveness of radical surgery and reduce treatment adherence.In ...BACKGROUND The development of prostate cancer(PC)frequently intensifies negative emotional states,such as anxiety and depression,which compromise the effectiveness of radical surgery and reduce treatment adherence.In this study,we hypothesized that psychological resilience plays a crucial role in this process and explored its impact.AIM To investigate the association of resilience with anxiety and depression in patients with PC and to analyze the influencing factors.METHODS We selected 147 patients with PC who visited Qingdao Traditional Chinese Medicine Hospital from January 2022 to June 2024.The resilience scores of patients with PC were assessed using the Connor-Davidson Resilience Scale(CDRISC)from the tenacity,self-improvement,and optimism dimensions.Based on the total CD-RISC score,patients were categorized into groups A(total CD-RISC score>63 points,n=69)and B(total CD-RISC score≤63 points,n=78)for comparative analysis of anxiety[Hamilton Anxiety Rating Scale(HAMA)],depression[Hamilton Depression Rating Scale(HAMD)],sexual function[International Index of Erectile Function-5(IIEF-5)and Sexual Life Quality Questionnaire-Quality of Life(SLQQ-QOL)],and quality of life[the EORTC Core Quality of Life Question naire(QLQ-C30)].The association between CD-RISC and the above indicators was analyzed with Spearman correlation coefficients,and the influencing factors of resilience in patients with PC were identified with binary logistic regression.RESULTS Group A demonstrated statistically lower HAMA and HAMD scores and markedly higher scores of IIEF-5,SLQQQOL,and various QLQ-C30 aspects.Correlation analysis revealed that CD-RISC was significantly negatively correlated with HAMA and HAMD scores and significantly positively correlated with IIEF-5,SLQQ-QOL,and QLQ-C30 total scores.Binary logistic regression analysis revealed educational and per capita monthly household income levels as significant influencing factors of resilience in patients with PC.CONCLUSION Our results indicate a significant correlation of resilience with anxiety and depression in patients with PC.The milder the anxiety and depression emotions in patients,the higher their resilience.Further,assisting patients with PC to improve their educational and per capita monthly household income levels will help their resilience to some extent.展开更多
A non-negative latent factor(NLF)model is able to be built efficiently via a single latent factor-dependent,non-negative and multiplicative update(SLF-NMU)algorithm for performing precise representation to high-dimens...A non-negative latent factor(NLF)model is able to be built efficiently via a single latent factor-dependent,non-negative and multiplicative update(SLF-NMU)algorithm for performing precise representation to high-dimensional and incomplete(HDI)matrix from many kinds of big-data-related applications.However,an SLF-NMU algorithm updates a latent factor relying on the current update increment only without considering past learning information,making a resultant model suffer from slow convergence.To address this issue,this study proposes a proportional integral(PI)controller-enhanced NLF(PI-NLF)model with two-fold ideas:1)Designing an increment refinement(IR)mechanism,which formulates the current and past update increments as the proportional and integral terms of a PI controller,thereby assimilating the past update information into the learning scheme smoothly with high efficiency;2)Deriving an IR-based SLF-NMU(ISN)algorithm,which updates a latent factor following the principle of an IR mechanism,thus significantly accelerating an NLF model's convergence rate.The simulation results on eight HDI matrices collected by real applications validate that a PI-NLF model outstrips several leading-edge models in both computational efficiency and accuracy when estimating missing data within an HDI matrix.The proposed PI-NLF model can be effectively applied to applications involving HDI matrix like e-commerce system,social network,and cloud service system.The code is available at https://github.com/yuanyeswu/PINLF/blob/mainIPINLF-code.zip.展开更多
BACKGROUND Pain often predisposes patients with diabetic foot ulcers(DFUs)to negative emotional states,such as anxiety and depression,which can significantly impair treatment outcomes and recovery.However,very few stu...BACKGROUND Pain often predisposes patients with diabetic foot ulcers(DFUs)to negative emotional states,such as anxiety and depression,which can significantly impair treatment outcomes and recovery.However,very few studies have explored the relationship between anxiety,depression,and pain in DFUs,as well as the associated risk factors.AIM To analyze the correlation between anxiety,depression,and pain in patients with DFUs and to identify the associated risk factors.METHODS This study included 106 patients diagnosed with DFUs who were admitted to Tiantai County People’s Hospital between March 2022 and March 2024.The patients’anxiety levels were evaluated using Zung’s self-rating anxiety scale(SAS),depression status was assessed using Zung’s self-rating depression scale(SDS),and pain intensity was assessed using the visual analog scale(VAS).Subsequently,correlations between SAS,SDS,and VAS scores were analyzed.Univariate and multivariate analyses were conducted to explore the risk factors that contributed to anxiety and depression in patients with DFUs.RESULTS Among the 106 patients,39.62%exhibited anxiety and 43.40%presented with depression.Most patients experiencing anxiety or depression exhibited mild symptoms,with no severe cases observed.Compared with asymptomatic patients,those with anxiety or depression had significantly higher VAS scores.Correlation analysis indicated a significant positive relationship between both SAS and SDS scores and the VAS score.Univariate analysis identified sex,age,Wagner’s grade,presence of other complications,and smoking history as factors significantly associated with anxiety and depression.Multivariate analysis further confirmed that younger age,higher Wagner’s grade,and higher VAS scores were independent predictors of anxiety and depression.CONCLUSION This study reveals a significant positive correlation between anxiety,depression,and pain in patients with DFUs.This finding suggests that timely and effective pain intervention may be beneficial in alleviating negative emotions such as anxiety and depression.In addition,younger age(<50 years),higher Wagner’s grade,and higher VAS scores increase the risk of developing anxiety and depression in this patient population.展开更多
BACKGROUND:Sepsis may increase the risk of long-term cardiovascular outcomes.This study aims to investigate association between sepsis survivorship and cardiovascular outcomes and to identify risk factors.METHODS:We c...BACKGROUND:Sepsis may increase the risk of long-term cardiovascular outcomes.This study aims to investigate association between sepsis survivorship and cardiovascular outcomes and to identify risk factors.METHODS:We conducted a comprehensive systematic search of MEDLINE,EMBASE,the Cochrane Library,Wanfang,and CNKI from database inception through May 2025,without language restrictions.The primary outcome was a composite of myocardial infarction,stroke,congestive heart failure,or cardiovascular death.To evaluate the association between sepsis survivors and cardiovascular outcomes,we calculated cumulative incidence rates and hazard ratios(HRs)with corresponding 95%confi dence intervals(95%CIs).RESULTS:Twenty-fi ve observational studies comprising 7,525,271 participants were included.The pooled cumulative incidence of major cardiovascular events was 9.0%(95%CI:6.1%-11.9%),myocardial infarction 2.4%(95%CI:1.6%-3.1%),stroke 4.9%(95%CI:3.8%-6.1%),and congestive heart failure 8.6%(95%CI:4.6%-12.6%).Compared with non-sepsis controls,sepsis survivors had a signifi cantly higher risk of major cardiovascular events(HR:1.54;95%CI:1.32-1.79),myocardial infarction(HR:1.41;95%CI:1.29-1.54),stroke(HR:1.45;95%CI:1.32-1.60),and congestive heart failure(HR:1.51;95%CI:1.46-1.56).Risk factors associated with increased cardiovascular events in sepsis survivors included age≤45 years,male,hyperlipidemia,and multiple comorbidities.CONCLUSION:Adult sepsis survivors may face significantly increased risks of long-term cardiovascular outcomes.Both common cardiovascular risk factors and sepsis-related pathophysiological changes contribute to this association.展开更多
Objectives:This systematic review and meta-analysis aimed to identify and synthesize the factors correlated with posttraumatic growth(PTG)in patients with colorectal cancer(CRC).Methods:PubMed,Web of Science,Embase,Ps...Objectives:This systematic review and meta-analysis aimed to identify and synthesize the factors correlated with posttraumatic growth(PTG)in patients with colorectal cancer(CRC).Methods:PubMed,Web of Science,Embase,PsycINFO,CINAHL,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang database,China Science and Technology Journal Database(VIP)and SinoMed were searched for studies that reported data on the correlated factors associated with PTG in patients with CRC from inception to September 3,2024.The methodological quality of the included studies was assessed via the Agency for Healthcare Research and Quality(AHRQ)methodology checklist and the Newcastle-Ottawa Scale(NOS).Pearson correlation coefficient(r)was utilized to indicate effect size.Meta-analysis was conducted in R Studio.Results:Thirty-one eligible studies encompassing 6,400 participants were included in this review.Correlated factors were identified to be significantly associated with PTG in patients with CRC including demographic factors:residential area(r=0.13),marital status(r=0.10),employment status(r=0.18),education level(r=0.19),income level(r=0.16);disease-related factors:time since surgery(r=0.17),stoma-related complications(r=0.14),health-promoting behavior(r=0.46),and sexual function(r=0.17);psychosocial factors:confrontation coping(r=0.68),avoidance coping(r=-0.65),deliberate rumination(r=0.56),social support(r=0.47),family function(r=0.50),resilience(r=0.53),selfefficacy(r=0.91),self-compassion(r=-0.32),psychosocial adjustment(r=0.39),gratitude(r=0.45),stigma(r=-0.65),self-perceived burden(r=-0.31),fear of cancer recurrence(r=-0.45);and quality of life(r=0.32).Conclusions:This meta-analysis identified 23 factors associated with PTG in CRC patients.Medical workers can combine those relevant factors from the perspective of positive psychology,further explore the occurrence and development mechanism of PTG,and establish targeted interventions to promote PTG.展开更多
Border-associated macrophages are located at the interface between the brain and the periphery, including the perivascular spaces, choroid plexus, and meninges. Until recently, the functions of border-associated macro...Border-associated macrophages are located at the interface between the brain and the periphery, including the perivascular spaces, choroid plexus, and meninges. Until recently, the functions of border-associated macrophages have been poorly understood and largely overlooked. However, a recent study reported that border-associated macrophages participate in stroke-induced inflammation, although many details and the underlying mechanisms remain unclear. In this study, we performed a comprehensive single-cell analysis of mouse border-associated macrophages using sequencing data obtained from the Gene Expression Omnibus(GEO) database(GSE174574 and GSE225948). Differentially expressed genes were identified, and enrichment analysis was performed to identify the transcription profile of border-associated macrophages. CellChat analysis was conducted to determine the cell communication network of border-associated macrophages. Transcription factors were predicted using the ‘pySCENIC' tool. We found that, in response to hypoxia, borderassociated macrophages underwent dynamic transcriptional changes and participated in the regulation of inflammatory-related pathways. Notably, the tumor necrosis factor pathway was activated by border-associated macrophages following ischemic stroke. The pySCENIC analysis indicated that the activity of signal transducer and activator of transcription 3(Stat3) was obviously upregulated in stroke, suggesting that Stat3 inhibition may be a promising strategy for treating border-associated macrophages-induced neuroinflammation. Finally, we constructed an animal model to investigate the effects of border-associated macrophages depletion following a stroke. Treatment with liposomes containing clodronate significantly reduced infarct volume in the animals and improved neurological scores compared with untreated animals. Taken together, our results demonstrate comprehensive changes in border-associated macrophages following a stroke, providing a theoretical basis for targeting border-associated macrophages-induced neuroinflammation in stroke treatment.展开更多
基金China Health and Retirement Longitudinal Study(CHARLS)the 2022-2023 Nursing Research Project of Chinese Medical Association Publishing House(Grant No.CMAPH-NRD2022024)。
文摘Background:The trajectory of intrinsic capacity(IC)among the older population is characterized by its diversity and is predictive of adverse health outcomes such as disability,nursing home admission,decline in quality of life,and mortality.Gaining an understanding of the trajectory of IC and the factors that influence it is of paramount importance for fostering healthy aging.This research is focused on exploring the trajectory of IC among older adults in China and examining the factors that influence it.Methods:This observational longitudinal cohort study leveraged data from the China Health and Retirement Longitudinal Study(CHARLS),which was conducted in the years 2011,2013,and 2015.For the purpose of this analysis,a total of 2,233 participants who were aged 60 and over were included.A Growth Mixture Model(GMM)was utilized to define trajectory categories for IC.Influential factors were ascertained based on the health ecology model,and binary logistic regression analysis was utilized to investigate the factors linked with the different trajectory categories.Results:Two distinct trajectory classes of IC were identified:Class 1,the normal-stable group,encompassed 90.4%of the elderly population,while Class 2,the declining group,made up 9.6%.Advanced age and a history of stroke were found to be significantly associated with Class 2.High scores in activities of daily living(ADL),employment status,receiving primary or junior high school education,and residence in the East or Central regions of China were significantly linked with Class 1.Conclusion:The trajectory of IC among older Chinese adults is marked by its heterogeneity.Advanced age and a history of stroke are significant risk factors for a declining IC trajectory,while higher ADL scores,being employed,receiving primary or junior high school education,and residing in the East or Central regions of China are protective factors associated with a stable IC trajectory.Healthcare institutions must closely monitor IC levels and understand these trajectory patterns to implement personalized and targeted interventions promptly to maintain IC at a healthy level and advocate for healthy aging.
基金supported by Guangdong Basic and Applied Basic Research Foundation(Nos.2023A1515110824 and 2025A1515011839)Shenzhen Science and Technology Program(No.RCBS20231211090638066).
文摘Understanding water chemistry in karst regions is crucial for improving global water resource management and deepening our knowledge of the biogeochemical cycles shaping these sensitive environments.Despite advance-ments in karst hydrology,significant gaps remain in long-term trends,underlying processes,and quantitative effects of environmental changes.This is especially true in areas like the Wujiang River(WJ)in China,where human activities such as reservoir construction and land use/cover changes have accelerated hydrochemical changes.We combined recent and historical monitoring data to provide a detailed analysis of the spatial and temporal characteristics,evolution,and controlling factors of major ions in WJ.These findings are important for local water management and contribute to global efforts to manage similar karst systems facing human-induced pressures.Our research shows clear seasonal differences in solute concentrations,with higher levels during the dry season.WJ’s water is rich in calcium,with Ca-HCO_(3) ion pairs being the most common.Reservoir monitor-ing stations show much higher levels of NO_(3)^(−)and SO_(4)^(2−)compared to river-type stations,likely due to longer hydraulic retention time and increased acid deposition.The study confirms the significant role of pH and water temperature in rock weathering processes.Land use/cover changes were identified as the primary drivers of solute variations(46.37%),followed by lithology(13.92%)and temperature(8.35%).Over the past two decades,in-tense carbonate weathering has been observed,especially during wet seasons.Among karstic provinces,Guizhou Province stands out with the highest ion concentrations,indicative of its extensive karst coverage and heightened weathering processes.
基金Supported by Open Fund Project of the Engineering Technology Research Center of Characteristic Medicinal Plants of Fujian(PP202003).
文摘This paper provides a systematic review of the histochemical localization,content characteristics,and influencing factors of saponins in Pseudostellaria heterophylla based on an extensive literature survey.It provides an in-depth analysis and summary of the effects of biological factors,environmental conditions,agronomic practices,processing methods,and continuous cropping obstacles on the synthesis of P.heterophylla saponins,as well as their underlying mechanisms.Based on identified gaps in the current literature,future research directions and prospects are proposed.The findings of this review offer valuable insights for advancing the understanding of the saponin biosynthesis mechanisms in P.heterophylla and for enhancing its quality.
基金Supported by the National Natural Science Foundation of China,No.82402789Beijing Jishuitan Hospital Youcai Plan,No.KYYC202402+1 种基金Beijing Jishuitan Research Funding,No.HL202402and Beijing Natural Science Foundation,No.L232062,No.L222063.
文摘BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different factors.AIM To investigate the key determinants of aseptic loosening,we performed a systematic review and meta-analysis.METHODS A comprehensive search of PubMed,Web of Science,EMBASE,and the Cochrane Library was conducted,encompassing studies from database inception to January 1,2025.Meta-analyses were performed to evaluate factors associated with aseptic loosening following pTHA.Inclusion and exclusion criteria were systematically applied at each stage to ensure methodological transparency and reproducibility.Study quality was assessed using standardized categories.Pooled odds ratio(OR)with corresponding 95%confidence interval were calculated with random-or fixed-effects models to generate reliability estimates,and study heterogeneity was visualized using forest plots.Ten factors,categorized into patient-,surgeon-,and device-related domains,were reviewed and meta-analyzed.Funnel plot analysis demonstrated a relatively symmetrical distribution,suggesting minimal publication bias.RESULTS A meta-analysis of 20 studies(520789 participants)found a pooled prevalence of 1.96%.Significant risk factors for aseptic loosening after pTHA included elevated body mass index(OR=1.116,P<0.001),higher Charlson comorbidity index(OR=1.378,P<0.001),prosthesis-related factors(OR=1.497,P<0.001),and adverse lifestyles(OR=2.198,P=0.037).Protective factors were non-white race(OR=0.445,P<0.001)and favorable genetics(OR=0.723,P<0.001).Male sex increased risk(OR=1.232,P=0.016),while age and anatomy were not significant.Surgical expertise showed a slight protective effect(OR=1.048,P<0.001).A comprehensive understanding of the modifiable and non-modifiable factors contributing to aseptic loosening after pTHA requires consideration of patient-related factors,surgical expertise,and prosthesis characteristics.CONCLUSION The identification of these factors is critical for risk mitigation.High-risk patients should receive targeted counseling regarding individualized profiles.Further studies are warranted to establish clearer causal relationships and identify additional contributing factors.
文摘BACKGROUND Esophageal cancer is highly malignant and frequently metastasizes to bones.Concomitant depression worsens prognosis;however,its incidence and determinants in this specific population remain poorly defined.AIM To determine the incidence of depression and its independent risk factors in patients with esophageal cancer and bone metastasis.METHODS A total of 100 consecutive eligible patients admitted between March 2022 and March 2025 were recruited.Depression was assessed with the Beck Depression Inventory-II;scores>4 defined the depression group(n=42)and scores≤4 the non-depression group(n=58).Demographic,clinical,and laboratory variables were compared between the groups.Multivariate logistic regression was used to identify independent risk factors.RESULTS Depression prevalence was 42.0%(42/100).Univariate analysis demonstrated significant differences in monthly per-capita household income,education level,social support,sleep disorders,and serum high-sensitivity C-reactive protein(all P<0.05);no differences were observed in sex,age,tumor characteristics,or other laboratory indices(all P>0.05).Multivariable analysis revealed the following independent risk factors for depression:Low income[odds ratio(OR)=2.66,95%confidence interval(CI):1.17-6.03],low education(OR=2.46,95%CI:1.08-5.61),low social support(OR=5.10,95%CI:1.81-14.39),sleep disorders(OR=2.79,95%CI:1.23-6.35),and elevated high-sensitivity C-reactive protein(OR=1.31 per unit increase,95%CI:1.18-1.46).CONCLUSION Depression is common among patients with esophageal cancer and bone metastasis.Low socioeconomic status,limited education,insufficient social support,sleep disturbances,and systemic inflammation were independent predictors.Interventions that address these modifiable factors may reduce depression risk in this population.
基金supported by Korea Institute of Police Technology(KIPoT)grant funded by the Korea government(KNPA)(Project Name:Development of Lv.4 Driving Ability Evaluation Technology for Autonomous Vehicles Based on Real Roads/Project Number:RS-2023-00238253).
文摘Analyzing the driving behavior of autonomous vehicles(AV)in mixed traffic conditions at urban intersections has become increasingly important for improving intersection design,providing infrastructure-based guidance information,and developing capability-enhanced AV perception systems.This study investigated the contributing factors affecting AV driving behavior using theWaymo Open Dataset.Binarized autonomous driving stability metrics,derived via a kernel density estimation,served as the target variables for a random forest classification model.The model’s input variables included 15 factors divided into four types:intersection-related,surrounding object-related,road infrastructure-related,and time-of-day-related types.The random forest classification model was employed to identify the key factors affecting autonomous driving behavior.In addition,the identified factors were further ranked based on feature importance.SHAP analysis was utilized to enhance model interpretability by quantifying the contribution of each factor and identifying their directional impacts.The type of intersection factor was found to have an importance of 0.243 and was the most influential factor on autonomous driving behavior.On average,intersection-related factors had an importance of 0.196,which is approximately a 31.1%margin over the average importance of surrounding object-related factors.Additionally,the surrounding object-related factors that were collected through sensors on the autonomous vehicle had a high degree of feature importance,especially with the number of pedestrians having the highest importance(0.107)of the types of objects.The correlation between these findings can contribute to the development of various treatments to improvemore harmonized AVs’maneuvering with other road users and facilities in urban mixed traffic environments.
基金supported by the Foundation Project:National Natural Science.Foundation of China(Nos.:82460249,82100417,81760094)The Foundation of Jiangxi Provincial Department of Science and Technology Outstanding Youth Fund Project(20212BAB206022,20242BAB23080).
文摘Objective:Leucine-rich alpha-2 glycoprotein 1(Lrg1)could regulate diverse cells in cerebral ischemiareperfusion.Our study seeks to uncover Lrg1’s impact on endothelial cell heterogeneity via differentiation pathways and transcription factors.Method:The CSOmap model measured cell-to-brain-center distances using single-cell RNA sequencing(scRNA-seq)data in middle cerebral artery occlusion reperfusion(MCAO/R).Monocle2 mapped endothelial differentiation paths.Gene set enrichment analysis(GSEA)analyzed endothelial subcluster variations.Database searches revealed a zinc finger MIZ-type containing 1 protein-frizzled 3(Zmiz1-Fzd3)promoter interaction.Endothelial cells were transfected with a Fzd3 promoter-luciferase plasmid.Polymerase chain reaction(PCR)and western blotting assessed MCAO/R or Zmiz1 overexpression effects on Fzd3-related mRNA and proteins.A retroviral vector carrying Zmiz1 was injected into the brains of mice to study its effect on Fzd3.Result:Lrg1−/−mice exhibited elevated cell adhesion proteins and decreased microvascular leakage after MCAO/R.CSOmap showed widened astrocyte spacing in thesemice.RSS revealed Zmiz1 overexpression inMCAO/R+Lrg1−/−mice.MCAO/R and pcDNA3-Zmiz1 transfection both enhanced luciferase activity with Fzd3,indicating Zmiz1 binding to Fzd3.Retroviral Zmiz1 injection or knockdown disrupted ischemic brain tight junctions,highlighting Zmiz1’s key role in blood-brain barrier protection,likely through Fzd3 pathway modulation.Conclusion:The findings indicate Lrg1 knockout induces endothelial differentiation by activating Zmiz1,which is crucial for maintaining blood-brain barrier function,possibly via modulating the Fzd3 pathway.
基金financially supported by the National Natural Science Foundation of China(No.52174297).
文摘The endpoint carbon content in the converter is critical for the quality of steel products,and accurately predicting this parameter is an effective way to reduce alloy consumption and improve smelting efficiency.However,most scholars currently focus on modifying methods to enhance model accuracy,while overlooking the extent to which input parameters influence accuracy.To address this issue,in this study,a prediction model for the endpoint carbon content in the converter was developed using factor analysis(FA)and support vector machine(SVM)optimized by improved particle swarm optimization(IPSO).Analysis of the factors influencing the endpoint carbon content during the converter smelting process led to the identification of 21 input parameters.Subsequently,FA was used to reduce the dimensionality of the data and applied to the prediction model.The results demonstrate that the performance of the FA-IPSO-SVM model surpasses several existing methods,such as twin support vector regression and support vector machine.The model achieves hit rates of 89.59%,96.21%,and 98.74%within error ranges of±0.01%,±0.015%,and±0.02%,respectively.Finally,based on the prediction results obtained by sequentially removing input parameters,the parameters were classified into high influence(5%-7%),medium influence(2%-5%),and low influence(0-2%)categories according to their varying degrees of impact on prediction accuracy.This classi-fication provides a reference for selecting input parameters in future prediction models for endpoint carbon content.
基金The authors extend their appreciation to the Ongoing Research Funding Program,number(ORF2025R705),King Saud University,Riyadh,Saudi Arabia,for funding this work.
文摘The study aims to determine the validity and reliability of the Wechsler Preschool and Primary Scale of Intelligence–Third Edition(WPPSI-III)scores in a sample of kindergarten and lower primary pupils from Khartoum State,Sudan.It also aims to examine whether test’s factor structure in this sample replicated that of the original WPPSI-III.The study sample consisted of 384 kindergarten and primary school children in Khartoum State(females=50%mean age=4.14,SD=1.37),selected using stratified random sampling across its seven localities:Khartoum,Jebel Awliya,Khartoum Bahri,East Nile,Omdurman,Ombada,Karari.For concurrent validation,the children additionally completed the Goodenough Draw-a-Man Test,and the Colored Progressive Matrices.WPPSI-III scores demonstrated high internal consistency across the subtest items.Confirmatory factor analysis indicators for total,verbal,and performance intelligence were all excellent.The scale also showed weak to strong score stability ranging from 0.25(weak)to 0.88(strong)based on the Spearman-Brown equation,0.25 to 0.75 based on the Guttman split-half method.The Cronbach’s alpha coefficient scores ranged from 0.54 to 0.93.The WPPSI-III and Goodenough Draw-a-Man Test scores concurrent validity scores were poor(0.05)to modest(0.31),and while those with the Colored Progressive Matrices test were poor(r=0.04–0.18).Thesefindings provide evidence to suggest that the WPPSI-III is appropriate for research use with kindergarten and lower primary school students in Khartoum State,Sudan.
基金Mid-term Results of the 2024 Langfang Normal University Special Teaching Reform Project on Innovation and Entrepreneurship Education Reform,“Research on the Evaluation System of Innovation and Entrepreneurship Ability for Normal University Students Based on Big Data Application-A Case Study of Langfang Normal University”(Project No.:CXJG2024-06)。
文摘Under the National Innovation-Driven Development Strategy,establishing a scientifically sound evaluation system for normal university students’innovation and entrepreneurship capabilities serves as a crucial foundation for optimizing innovation education models and enhancing teacher candidates’comprehensive competencies.Based on existing indicator frameworks,we designed a questionnaire and applied exploratory factor analysis(EFA)to screen indicators,reduce dimensionality,and analyze weighting.This process identified key metrics for evaluating pedagogical students’innovation capacities,ultimately constructing a targeted assessment system for normal university students.The study provides theoretical support for cultivating teacher trainees’innovative capabilities while contributing to the national innovation strategy implementation.
基金Supported by Tianjin Municipality Health Science and Technology Project,No.TJWJ2023MS052.
文摘BACKGROUND Dental implants are widely used to replace missing teeth.Currently,clinicians assess osseointegration success by measuring the implant’s stability within the bone and monitoring the marginal tissue height.Diabetes,especially type 2 diabetes mellitus(T2DM),has been reported to impair implant healing,drastically reducing implant success rates.AIM To analyze the high-risk factors for inflammatory response and prognosis after dental implantation in patients with T2DM,and provide strong evidence for reducing the incidence of postimplant peri-implantitis(PI).METHODS We performed a retrospective review of 146 patients with T2DM who had dental implants placed at Tianjin Fifth Central Hospital,between September 2021 and September 2023,which was regarded as the observation group.Moreover,60 ageand gender-matched individuals with normal blood glucose levels served as the control group.The general information,postoperative periodontal indices,and levels of inflammatory factors were comprehensively analyzed and compared.Furthermore,the incidence of postimplant PI was counted,and multivariate logistic regression was used to identify the determinants of postimplant PI.RESULTS In terms of the periodontal indices,the probing depth,modified sulcus bleeding index,and marginal bone loss in the observation cohorts began to increase significantly at 6 months and 3 months,respectively,after the completion of dental implant restoration.The T2DM cases demonstrated significantly elevated counts of leukocytes,lymphocytes,and neutrophils compared to the controls at 24 hours postoperatively.Moreover,the TNF-α,IL-1β,and IL-6 concentrations started to increase significantly in the gingival crevicular fluid 3 months after the completion of dental implant restoration in both cohorts,with the observation group exhibiting higher levels than the controls at each time point.63 out of the 146 cases developed PI.Multivariate logistic regression analysis indicated that high glycosylated hemoglobin levels,smoking,daily tooth-brushing frequency of less than once,and the anterior tooth as the implant site independently contributed to postimplant PI in T2DM cases,while a tooth-brushing duration of≥3 minutes was a protective factor.CONCLUSION Patients with T2DM are at risk of developing PI following dental implantation.Clinically,it is necessary to enhance the identification of risk factors for postimplant PI,improve risk prediction,prevention,and control,and formulate targeted intervention countermeasures to reduce the occurrence of postimplant PI.
文摘BACKGROUND Cardiovascular(CV)complications are common in intensive care unit(ICU)patients after gastrointestinal surgery and are associated with increased mortality and prolonged hospital stay.The optimization of postoperative nursing interventions,particularly pain management,is crucial for reducing such complications.AIM To investigate the effects of enhanced recovery nursing on CV complications after gastrointestinal surgery in ICU patients and associated risk factors.METHODS A retrospective analysis was conducted on 78 adult patients who underwent gastrointestinal surgery in the ICU of our hospital between February 2023 and September 2024.Among them,40 patients received standard care(control group),while 38 received enhanced recovery nursing(observation group).We compared the incidence of CV complications and nursing satisfaction between the two groups.Patients were divided into CV complication and non-complication groups based on complication occurrence,and logistic regression analysis was used to identify risk factors.RESULTS In the control and observation groups,the incidence of CV complications was 30.0%(12/40)and 18.4%(7/38),with a nursing satisfaction rate of 70.0%(28/40)and 92.1%(35/38),respectively.The postoperative pain score at 14 days was significantly lower in the observation group(0.27±0.15)compared to the control group(1.65±0.37),with all differences being statistically significant(P<0.05).Univariate analysis indicated significant differences in age,body mass index,hypertension,diabetes,smoking history,history of heart failure,and previous myocardial infarction(P<0.05).Multivariate logistic regression identified heart failure history,previous myocardial infarction,age,hypertension,and diabetes as independent risk factors,with odds ratios of 1.195,1.528,1.062,1.836,and 1.942,respectively(all P<0.05).CONCLUSION Implementing enhanced recovery nursing for ICU patients after gastrointestinal surgery is beneficial in reducing the incidence of CV complications and improving nursing satisfaction.
基金Supported by the Wannan Medical College Teaching Hospital Special Application for Scientific Research,No.WK2023JXYY036the Anhui Provincial Translational Clinical Medical Research Special Application,No.202204295107020062.
文摘BACKGROUND Bile leakage is a common complication following laparoscopic common bile duct exploration(LCBDE)with primary duct closure(PDC).Identifying and analyzing the risk factors associated with bile leakage is crucial for improving surgical outcomes.AIM To explore the value analysis of common risk factors for bile leakage after LCBDE and PDC,with a focus on strict adherence to indications.METHODS Clinical data of 106 cases undergoing LCBDE+PDC in the Hepatobiliary and Pancreatic Surgery Department(Division 1)of Chuzhou First People’s Hospital from April 2019 to March 2024 were collected.Retrospective and multiple factor regression analysis were conducted on common risk factors for bile leakage.The change in surgical time was analyzed using the cumulative summation(CUSUM)method,and the minimum number of cases required to complete the learning curve for PDC was obtained based on the proposed fitting curve by identifying the CUSUM maximum value.RESULTS Multifactor logistic regression analysis showed that fibrinous inflammation and direct bilirubin/indirect bilirubin were significant independent high-risk factors for postoperative bile leakage(P<0.05).The time to drain removal and length of hospital stay in cases without bile leakage were significantly shorter than in cases with bile leakage(P<0.05),with statistical significance.The CUSUM method indicated that a minimum of 51 cases were required for the surgeon to complete the learning curve(P=0.023).CONCLUSION With a good assessment of duodenal papilla sphincter function,unobstructed bile-pancreatic duct convergence,exact stone clearance,and sufficient surgical experience to complete the learning curve,PDC remains the preferred method for bile duct closure and is worthy of clinical promotion.
文摘BACKGROUND The development of prostate cancer(PC)frequently intensifies negative emotional states,such as anxiety and depression,which compromise the effectiveness of radical surgery and reduce treatment adherence.In this study,we hypothesized that psychological resilience plays a crucial role in this process and explored its impact.AIM To investigate the association of resilience with anxiety and depression in patients with PC and to analyze the influencing factors.METHODS We selected 147 patients with PC who visited Qingdao Traditional Chinese Medicine Hospital from January 2022 to June 2024.The resilience scores of patients with PC were assessed using the Connor-Davidson Resilience Scale(CDRISC)from the tenacity,self-improvement,and optimism dimensions.Based on the total CD-RISC score,patients were categorized into groups A(total CD-RISC score>63 points,n=69)and B(total CD-RISC score≤63 points,n=78)for comparative analysis of anxiety[Hamilton Anxiety Rating Scale(HAMA)],depression[Hamilton Depression Rating Scale(HAMD)],sexual function[International Index of Erectile Function-5(IIEF-5)and Sexual Life Quality Questionnaire-Quality of Life(SLQQ-QOL)],and quality of life[the EORTC Core Quality of Life Question naire(QLQ-C30)].The association between CD-RISC and the above indicators was analyzed with Spearman correlation coefficients,and the influencing factors of resilience in patients with PC were identified with binary logistic regression.RESULTS Group A demonstrated statistically lower HAMA and HAMD scores and markedly higher scores of IIEF-5,SLQQQOL,and various QLQ-C30 aspects.Correlation analysis revealed that CD-RISC was significantly negatively correlated with HAMA and HAMD scores and significantly positively correlated with IIEF-5,SLQQ-QOL,and QLQ-C30 total scores.Binary logistic regression analysis revealed educational and per capita monthly household income levels as significant influencing factors of resilience in patients with PC.CONCLUSION Our results indicate a significant correlation of resilience with anxiety and depression in patients with PC.The milder the anxiety and depression emotions in patients,the higher their resilience.Further,assisting patients with PC to improve their educational and per capita monthly household income levels will help their resilience to some extent.
基金supported in part by the National Natural Science Foundation of China(62372385,62272078)the Chongqing Natural Science Foundation(CSTB2023NSCQ-LZX0069).
文摘A non-negative latent factor(NLF)model is able to be built efficiently via a single latent factor-dependent,non-negative and multiplicative update(SLF-NMU)algorithm for performing precise representation to high-dimensional and incomplete(HDI)matrix from many kinds of big-data-related applications.However,an SLF-NMU algorithm updates a latent factor relying on the current update increment only without considering past learning information,making a resultant model suffer from slow convergence.To address this issue,this study proposes a proportional integral(PI)controller-enhanced NLF(PI-NLF)model with two-fold ideas:1)Designing an increment refinement(IR)mechanism,which formulates the current and past update increments as the proportional and integral terms of a PI controller,thereby assimilating the past update information into the learning scheme smoothly with high efficiency;2)Deriving an IR-based SLF-NMU(ISN)algorithm,which updates a latent factor following the principle of an IR mechanism,thus significantly accelerating an NLF model's convergence rate.The simulation results on eight HDI matrices collected by real applications validate that a PI-NLF model outstrips several leading-edge models in both computational efficiency and accuracy when estimating missing data within an HDI matrix.The proposed PI-NLF model can be effectively applied to applications involving HDI matrix like e-commerce system,social network,and cloud service system.The code is available at https://github.com/yuanyeswu/PINLF/blob/mainIPINLF-code.zip.
文摘BACKGROUND Pain often predisposes patients with diabetic foot ulcers(DFUs)to negative emotional states,such as anxiety and depression,which can significantly impair treatment outcomes and recovery.However,very few studies have explored the relationship between anxiety,depression,and pain in DFUs,as well as the associated risk factors.AIM To analyze the correlation between anxiety,depression,and pain in patients with DFUs and to identify the associated risk factors.METHODS This study included 106 patients diagnosed with DFUs who were admitted to Tiantai County People’s Hospital between March 2022 and March 2024.The patients’anxiety levels were evaluated using Zung’s self-rating anxiety scale(SAS),depression status was assessed using Zung’s self-rating depression scale(SDS),and pain intensity was assessed using the visual analog scale(VAS).Subsequently,correlations between SAS,SDS,and VAS scores were analyzed.Univariate and multivariate analyses were conducted to explore the risk factors that contributed to anxiety and depression in patients with DFUs.RESULTS Among the 106 patients,39.62%exhibited anxiety and 43.40%presented with depression.Most patients experiencing anxiety or depression exhibited mild symptoms,with no severe cases observed.Compared with asymptomatic patients,those with anxiety or depression had significantly higher VAS scores.Correlation analysis indicated a significant positive relationship between both SAS and SDS scores and the VAS score.Univariate analysis identified sex,age,Wagner’s grade,presence of other complications,and smoking history as factors significantly associated with anxiety and depression.Multivariate analysis further confirmed that younger age,higher Wagner’s grade,and higher VAS scores were independent predictors of anxiety and depression.CONCLUSION This study reveals a significant positive correlation between anxiety,depression,and pain in patients with DFUs.This finding suggests that timely and effective pain intervention may be beneficial in alleviating negative emotions such as anxiety and depression.In addition,younger age(<50 years),higher Wagner’s grade,and higher VAS scores increase the risk of developing anxiety and depression in this patient population.
基金supported by Zhejiang Province Medical and Health Science and Technology Plan Project(2022KY241)Hangzhou Health Science and Technology Plan Project(ZD20230017).
文摘BACKGROUND:Sepsis may increase the risk of long-term cardiovascular outcomes.This study aims to investigate association between sepsis survivorship and cardiovascular outcomes and to identify risk factors.METHODS:We conducted a comprehensive systematic search of MEDLINE,EMBASE,the Cochrane Library,Wanfang,and CNKI from database inception through May 2025,without language restrictions.The primary outcome was a composite of myocardial infarction,stroke,congestive heart failure,or cardiovascular death.To evaluate the association between sepsis survivors and cardiovascular outcomes,we calculated cumulative incidence rates and hazard ratios(HRs)with corresponding 95%confi dence intervals(95%CIs).RESULTS:Twenty-fi ve observational studies comprising 7,525,271 participants were included.The pooled cumulative incidence of major cardiovascular events was 9.0%(95%CI:6.1%-11.9%),myocardial infarction 2.4%(95%CI:1.6%-3.1%),stroke 4.9%(95%CI:3.8%-6.1%),and congestive heart failure 8.6%(95%CI:4.6%-12.6%).Compared with non-sepsis controls,sepsis survivors had a signifi cantly higher risk of major cardiovascular events(HR:1.54;95%CI:1.32-1.79),myocardial infarction(HR:1.41;95%CI:1.29-1.54),stroke(HR:1.45;95%CI:1.32-1.60),and congestive heart failure(HR:1.51;95%CI:1.46-1.56).Risk factors associated with increased cardiovascular events in sepsis survivors included age≤45 years,male,hyperlipidemia,and multiple comorbidities.CONCLUSION:Adult sepsis survivors may face significantly increased risks of long-term cardiovascular outcomes.Both common cardiovascular risk factors and sepsis-related pathophysiological changes contribute to this association.
基金supported by the‘Double First-Class’Construction Specialized Discipline Project at Zhejiang University(No HL2024012).
文摘Objectives:This systematic review and meta-analysis aimed to identify and synthesize the factors correlated with posttraumatic growth(PTG)in patients with colorectal cancer(CRC).Methods:PubMed,Web of Science,Embase,PsycINFO,CINAHL,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang database,China Science and Technology Journal Database(VIP)and SinoMed were searched for studies that reported data on the correlated factors associated with PTG in patients with CRC from inception to September 3,2024.The methodological quality of the included studies was assessed via the Agency for Healthcare Research and Quality(AHRQ)methodology checklist and the Newcastle-Ottawa Scale(NOS).Pearson correlation coefficient(r)was utilized to indicate effect size.Meta-analysis was conducted in R Studio.Results:Thirty-one eligible studies encompassing 6,400 participants were included in this review.Correlated factors were identified to be significantly associated with PTG in patients with CRC including demographic factors:residential area(r=0.13),marital status(r=0.10),employment status(r=0.18),education level(r=0.19),income level(r=0.16);disease-related factors:time since surgery(r=0.17),stoma-related complications(r=0.14),health-promoting behavior(r=0.46),and sexual function(r=0.17);psychosocial factors:confrontation coping(r=0.68),avoidance coping(r=-0.65),deliberate rumination(r=0.56),social support(r=0.47),family function(r=0.50),resilience(r=0.53),selfefficacy(r=0.91),self-compassion(r=-0.32),psychosocial adjustment(r=0.39),gratitude(r=0.45),stigma(r=-0.65),self-perceived burden(r=-0.31),fear of cancer recurrence(r=-0.45);and quality of life(r=0.32).Conclusions:This meta-analysis identified 23 factors associated with PTG in CRC patients.Medical workers can combine those relevant factors from the perspective of positive psychology,further explore the occurrence and development mechanism of PTG,and establish targeted interventions to promote PTG.
基金supported by Qingdao Key Medical and Health Discipline ProjectThe Intramural Research Program of the Affiliated Hospital of Qingdao University,No. 4910Qingdao West Coast New Area Science and Technology Project,No. 2020-55 (all to SW)。
文摘Border-associated macrophages are located at the interface between the brain and the periphery, including the perivascular spaces, choroid plexus, and meninges. Until recently, the functions of border-associated macrophages have been poorly understood and largely overlooked. However, a recent study reported that border-associated macrophages participate in stroke-induced inflammation, although many details and the underlying mechanisms remain unclear. In this study, we performed a comprehensive single-cell analysis of mouse border-associated macrophages using sequencing data obtained from the Gene Expression Omnibus(GEO) database(GSE174574 and GSE225948). Differentially expressed genes were identified, and enrichment analysis was performed to identify the transcription profile of border-associated macrophages. CellChat analysis was conducted to determine the cell communication network of border-associated macrophages. Transcription factors were predicted using the ‘pySCENIC' tool. We found that, in response to hypoxia, borderassociated macrophages underwent dynamic transcriptional changes and participated in the regulation of inflammatory-related pathways. Notably, the tumor necrosis factor pathway was activated by border-associated macrophages following ischemic stroke. The pySCENIC analysis indicated that the activity of signal transducer and activator of transcription 3(Stat3) was obviously upregulated in stroke, suggesting that Stat3 inhibition may be a promising strategy for treating border-associated macrophages-induced neuroinflammation. Finally, we constructed an animal model to investigate the effects of border-associated macrophages depletion following a stroke. Treatment with liposomes containing clodronate significantly reduced infarct volume in the animals and improved neurological scores compared with untreated animals. Taken together, our results demonstrate comprehensive changes in border-associated macrophages following a stroke, providing a theoretical basis for targeting border-associated macrophages-induced neuroinflammation in stroke treatment.
