BACKGROUND Proton pump inhibitors(PPIs)are among the most commonly prescribed medications globally.While concerns exist regarding their association with adverse infection-related outcomes,their impact on coronavirus d...BACKGROUND Proton pump inhibitors(PPIs)are among the most commonly prescribed medications globally.While concerns exist regarding their association with adverse infection-related outcomes,their impact on coronavirus disease 2019(COVID-19)severity remains uncertain.Emerging preclinical data suggest immunomodulatory and antiviral properties of PPIs,yet clinical evidence is conflicting.AIM To investigate whether chronic pre-hospital PPI use is associated with improved outcomes in patients hospitalized with COVID-19.METHODS We conducted a retrospective case-control study of adult inpatients with severe acute respiratory syndrome coronavirus 2 infection admitted to a racially and ethnically diverse communityhospital in Massachusetts from July 2021 to March 2022. Patients were stratified by documented pre-hospital PPIuse. The primary outcomes were intensive care unit (ICU) admission, need for invasive mechanical ventilation, andin-hospital mortality. Multivariable logistic regression was used to adjust for demographics, comorbidities, andtreatment variables. Significance was set at P < 0.05.RESULTSAmong 248 patients, 83 (33.4%) were on PPIs prior to hospitalization. Compared to non-users, PPI users hadsignificantly lower rates of ICU admission (13.3% vs 24.8%, P = 0.034), mechanical ventilation (13.3% vs 25.5%, P =0.027), and in-hospital mortality (6.0% vs 17.6%, P = 0.013). Multivariable analysis confirmed these associations:ICU admission [adjusted odds ratios (aOR): 0.462, 95%CI: 0.223–0.955], mechanical ventilation (aOR: 0.447, 95%CI:0.216–0.923), and mortality (aOR: 0.144, 95%CI: 0.031–0.677). Findings were consistent across demographic andcomorbidity strata.CONCLUSIONIn this diverse, real-world United States cohort, chronic pre-hospital PPI use was independently associated withlower odds of intensive care unit admission, mechanical ventilation, and mortality among COVID-19 inpatients.These findings highlight a potentially protective role of PPIs and support continued therapy in eligible patients.展开更多
This case-control study evaluated the frequency of Glutathione S-transferase Mu 1(GSTM1)deletion and Glutathione S-transferase Alpha 1(GSTA1)mutation in chronic obstructive pulmonary disease(COPD)patients,whether they...This case-control study evaluated the frequency of Glutathione S-transferase Mu 1(GSTM1)deletion and Glutathione S-transferase Alpha 1(GSTA1)mutation in chronic obstructive pulmonary disease(COPD)patients,whether they had concomitant lung squamous cell carcinoma(LSCC)or not,to assess their connection with cancer susceptibility.By means of multivariate logistic regression analysis,the GSTM1 null genotype serves as a significant standalone risk factor for LSCC,in addition to variables like age,smoking history,emphysema,body mass index(BMI),albumin level,and neutrophil-to-lymphocyte ratio(NLR).A predictive model incorporating these factors demonstrated superior discriminative ability compared to the established COPD Lung Cancer Screening Score(COPD-LUCSS).展开更多
Randomized controlled trials(RCTs) are the gold standard in terms of study design, however, in the surgical setting conducting RCTs can often be unethical or logistically impossible. Case-control studies should become...Randomized controlled trials(RCTs) are the gold standard in terms of study design, however, in the surgical setting conducting RCTs can often be unethical or logistically impossible. Case-control studies should become the major study design used in surgical research when RCTs are unable to be conducted and definitely replacing case series which offer little insight into surgical outcomes and disease processes.展开更多
Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsist...Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.展开更多
This paper proposes an interdisciplinary talent training model that combines foreign language education with area studies.The model aims to cultivate international ocean affairs professionals with cross-cultural commu...This paper proposes an interdisciplinary talent training model that combines foreign language education with area studies.The model aims to cultivate international ocean affairs professionals with cross-cultural communication skills,in-depth regional and country knowledge,and practical expertise in ocean affairs.Additionally,the paper presents specific training pathways and policy recommendations for implementing this model.展开更多
In modern society,the globalization of literary works is evident,with exceptional literary pieces from various countries spreading worldwide.Among these,children’s literature,due to the specificity of its target audi...In modern society,the globalization of literary works is evident,with exceptional literary pieces from various countries spreading worldwide.Among these,children’s literature,due to the specificity of its target audience,imposes distinct requirements on children’s books,compelling translators to approach the text from a child’s perspective.“The Little Prince”has renowned both within and outside of China,and a careful reading of this work can provide us with much inspiration.To this end,the present study adopts the perspective of Gideon Toury’s Descriptive Translation Studies to conduct an in-depth analysis of the different English and Chinese translations in conjunction with the original French novel.This approach aims to better guide literary research and explores translation methods for children’s literature through the analysis of translation norms and rules.展开更多
Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth...Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth interviews with patients and families,anchored by Interactive Patient Par ticipation Theory,to analyze 4 high-severity adverse drug events(ADE)cases.Cases were purposively sampled from 8 communities in China's National Adverse Event Monitor Center(2018-2023).Semi-structured interviews explored patient perspectives,with data analyzed via thematic coding and triangulation against clinical records.Results:Five interconnected themes emerged:(1)erosion of trust,(2)communication breakdowns,(3)information asymmetry,(4)environmental inadequacies,and(5)technological alienation.Notably,75% of participants had≤high school education,and 50% used≥7 medications daily,compounding ADE risks.Conclusions:We considered elements mentioned by theory,exploring trust,communication,information,and suppor t as the root causes.In addition,we added“adaptability to new technology”as an impor tant and necessary component.It is impor tant and necessary to analyze typical adverse drug events from the perspectives of patients.展开更多
Mindfulness would enhance university students’emotional well-being and study engagement.However,the role of affect(positive and negative emotions)and psychological resources(psychological capital)linking mindfulness ...Mindfulness would enhance university students’emotional well-being and study engagement.However,the role of affect(positive and negative emotions)and psychological resources(psychological capital)linking mindfulness to study engagement remain underexplored.This cross-sectional study surveyed 688 Chinese university students(females=413,mean age=20.3,SD=0.83),using validated self-report measures of mindfulness,positive and negative emotions,psychological capital,and study engagement.Structural equation modeling and bias-corrected bootstrap analyses(5000 resamples)revealed that mindfulness directly enhanced positive emotions,psychological capital,and study engagement,while reducing negative emotions.Positive emotions partially mediated the positive effect of mindfulness on psychological capital and study engagement.Negative emotions partially and negatively mediated only the mindfulness-psychological capital link.Psychological capital independently mediated the mindfulness-engagement relationship,and two sequential mediation pathways emerged:(a)mindfulness→positive emotions→psychological capital→higher study engagement and(b)mindfulness→reduced negative emotions→psychological capital→higher study engagement.Consistent with broaden-and-build(B&B)theory and Conservation of Resources(COR)theory,these findings suggest that mindfulness fosters study engagement primarily by promoting positive emotional experiences and strengthening psychological capital.By implication,university student support programs should employ mindfulness-based interventions to cultivate emotional and psychological resources for higher students’engagement and overall well-being.展开更多
BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as exp...BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as expanding treatment indications,which affect the fair distribution of medical resources.There is limited research on ethical issues in the field of digestive endoscopy.AIM To investigate the level of ethical awareness among gastrointestinal endoscopy practitioners and analyze the ethical issues involved in gastrointestinal endoscopy technology.METHODS A questionnaire survey was performed to collect relevant data(gender,age,degree of education,professional title,personnel category,the level of understanding medical ethical principles,ethics training and its learning pathways)from gastrointestinal endoscopy practitioners at the Second Hospital of Dalian Medical University and Dalian Friendship Hospital,including licensed physicians and nurses(including trainees and graduate students).RESULTS The majority of gastrointestinal endoscopy practitioners have received training on ethics,but there is still considerable room for improvement in their ethical awareness.Different learning pathways may affect the mastery of ethical principles, and understanding of ethical principles is more easily achieved through hospital ethics institutions.CONCLUSIONTo address the ethical issues in gastrointestinal endoscopy technology, it is necessary to enhance the humanisticeducation of gastrointestinal endoscopy practitioners, incorporate ethical standards into the technology assessmentprocess, and establish a patient-centered diagnostic and treatment model to improve the ethical awareness of practitionersand achieve a balance between technology and ethics.展开更多
Escalating global energy demands and climate urgency necessitate advanced electrochemical energy conversion and storage technologies(EECSTs)like electrocatalysis and rechargeable batteries.Improving their performance ...Escalating global energy demands and climate urgency necessitate advanced electrochemical energy conversion and storage technologies(EECSTs)like electrocatalysis and rechargeable batteries.Improving their performance relies on elucidating reaction mechanisms and structure-performance relationships via in situ studies.This review summarizes recent in situ studies of EECSTs through a variety of advanced characterization techniques aiming at mapping reaction pathways for the rational design of overall high-performance reaction systems.We outline the principles,capabilities,advantages,and limitations of various in situ techniques.Their applications in in situ studies of fuel cells,water/CO_(2)electrolysis,and lithium batteries are highlighted with representative examples.These studies enable dynamic tracking of chemical and structural evolution of overall reaction systems,including materials,intermediates,products,and surroundings during operation,providing insights critical to rational system design.Future advancements will involve integrating multimodal in situ/operando approaches with artificial intelligence to enable real-time monitoring at practical scales.Such integration promises precise mechanistic insights and robust structure-performance correlations,ultimately accelerating the development of high-performance EECSTs aligned with sustainability and market requirements.展开更多
Objectives:In recent years,mental health has emerged as a pressing public health concern in China,driven by mounting societal pressures and fast-paced urban lifestyles.Physical activity,a well-established means of enh...Objectives:In recent years,mental health has emerged as a pressing public health concern in China,driven by mounting societal pressures and fast-paced urban lifestyles.Physical activity,a well-established means of enhancing psychological well-being,has received growing scholarly and policy attention.This study uses panel data from the 2020 and 2022 waves of the China Family Panel Studies(CFPS)to examine the impact of exercise frequency on mental health(with indicators such as CESD-8 depression scores)among college students and young employees,thereby providing empirical support for targeted mental health interventions.Methods:This study examines the relationship between individual exercise frequency and mental health among college students and young employees,using panel data from the 2020 and 2022 waves of the China Family Panel Studies(CFPS),with the Chinese version of the 8-item Center for Epidemiologic Studies Depression Scale(CESD-8)depression scores,self-rated health,and life satisfaction as outcome variables.Specifically,this study tests three hypotheses:(H1)increased exercise frequency significantly reduces depression symptoms and enhances well-being;(H2)the effects of exercise vary by social roles,with stronger mental health benefits among employed individuals and those with lower education;and(H3)lifestyle factors such as smoking amount,sleep duration,and Body Mass Index(BMI)partially mediate the relationship between exercise and mental health.Employing a two-way fixed effects model,baseline results indicate that a one-unit increase in exercise frequency significantly reduces the CESD-8 score by 0.183 points.To address potential endogeneity and spurious regression concerns,an instrumental variable(IV)approach is further applied.The heterogeneity analysis differentiates between students and employed individuals.Results:Among students,the effects of exercise on mental health are not statistically significant,regardless of education level.In contrast,for the employed,exercise demonstrates a significant positive impact on mental health,with particularly pronounced effects among those with lower educational attainment.These findings underscore the importance of promoting exercise as part of comprehensive mental health strategies.Mediation analysis indicates that the beneficial effect of exercise on mental health is partially transmitted through reductions in adverse health behaviors,especially smoking.Conclusions:Policymakers should integrate physical activity promotion into health interventions,prioritizing vulnerable groups to enhance psychological resilience and foster inclusive,health-oriented development.展开更多
AIM:To investigate the potential causal associations between 41 inflammatory cytokines and myopia using a two-sample Mendelian randomization(MR)approach.METHODS:Publicly available genome-wide association study(GWAS)da...AIM:To investigate the potential causal associations between 41 inflammatory cytokines and myopia using a two-sample Mendelian randomization(MR)approach.METHODS:Publicly available genome-wide association study(GWAS)datasets were utilized for this two-sample MR analysis.Inflammatory cytokine-related GWAS data were extracted from The University of Bristol’s Research Data Repository,and myopia-related GWAS data were obtained from the FinnGen project.Single nucleotide polymorphisms(SNPs)associated with inflammatory cytokines were systematically selected as instrumental variables(IVs)based on three rigorous criteria:relevance,independence,and exclusion of pleiotropy.Five MR methods were employed for causal inference:the inverse-variance weighted(IVW)method as the primary analysis,supplemented by MREgger regression,weighted median estimator,simple mode,and weighted mode approaches.Sensitivity analyses were performed to evaluate the robustness of the causal estimates.RESULTS:A total of 773 myopia-associated SNPs were identified.MR analysis revealed that higher levels of macrophage inflammatory protein 1-α(MIP-1α)were associated with a 17%reduced risk of myopia[odds ratio(OR)=0.83;95%confidence interval(CI):0.69-0.99;P<0.05].In contrast,elevated levels of eotaxin(OR=1.26;95%CI:1.07-1.47;P<0.01),stromal cell-derived factor-1α(SDF-1α;OR=1.68;95%CI:1.08-2.62;P<0.05),and interleukin-2 receptor subunit alpha(IL-2Rα;OR=1.25;95%CI:1.01-1.53;P<0.05)were significantly associated with an increased risk of myopia.Sensitivity analyses confirmed the reliability of these results.CONCLUSION:This study provides evidence supporting a causal relationship between specific inflammatory cytokines and myopia.MIP-1αmay act as a protective factor against myopia,while eotaxin,SDF-1α,and IL-2Rαare potential risk factors for myopia.These findings emphasize the critical role of inflammatory pathways in the pathogenesis of myopia,offering novel insights for the development of preventive and therapeutic strategies for myopia.展开更多
Background:Despite highly effective vaccines against SARS-CoV-2,COVID-19 vaccine hesitancy persisted in some populations in England during the pandemic,with rates and motivations for hesitancy varying by demographic g...Background:Despite highly effective vaccines against SARS-CoV-2,COVID-19 vaccine hesitancy persisted in some populations in England during the pandemic,with rates and motivations for hesitancy varying by demographic group.Addressing the drivers of vaccine hesitancy through targeted interventions in hesitant groups is a public health priority for better and more rapid control of disease spread.We aimed to characterise the determinants and subtypes of vaccine hesitancy and identify more persistent forms of hesitancy via analysis of vaccine uptake in a large cross-sectional cohort with linked National Health Service(NHS)data.展开更多
Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and wheth...Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and whether this association differs by baseline body-mass index(BMI).Methods:This retrospective cohort study used electronic health records from the TriNetX U.S.research network.Adults aged 20 years or older diagnosed with T2DM between 2016 and 2024 were included if they received any hypoglycemic agents within 3 months before and after diagnosis.Following 1:1 propensity score matching,both the GLP-1 RA user and non-user groups included 183,264 patients.The study outcome was defined as a diagnosis of malignant neoplasms.Hazard ratios(HRs)for overall and site-specific cancer risk were estimated using Cox proportional hazards models.Kaplan–Meier analysis and stratified analysis by BMI were performed.Results:Early GLP-1 RA use demonstrated a modest but significant association with reduced overall cancer risk(HR 0.93;95%CI:0.90–0.96).Reduced risks were noted for cancers of the digestive(HR 0.81),respiratory(HR 0.66),and female genital(HR 0.87)systems.In stratified analysis,benefits were more pronounced in patients with BMI≥30,particularly for pancreatic and colorectal cancers.Conclusion:Early initiation of GLP-1 receptor agonists in patients with diagnosed T2DM was associated with a modest reduction in overall cancer risk,particularly among individuals with obesity.These findings highlight the dual metabolic and oncologic value of prompt GLP-1 RA therapy.展开更多
Through the questionnaire survey and comparative studies on tourist satisfaction of tourism services among three world heritage sites,i.e.Huangshan Mountain,Lushan Mountain and Wuyi Mountain,this study pointed out the...Through the questionnaire survey and comparative studies on tourist satisfaction of tourism services among three world heritage sites,i.e.Huangshan Mountain,Lushan Mountain and Wuyi Mountain,this study pointed out the problems in tourism services of three scenic areas and then put forward relevant countermeasures for the management of scenic areas.展开更多
AIM: Glutathione S-transferases (GSTs) are involved in the detoxification of many potential carcinogens and appear to play a critical role in the protection from the effects of carcinogens. The contribution of glutath...AIM: Glutathione S-transferases (GSTs) are involved in the detoxification of many potential carcinogens and appear to play a critical role in the protection from the effects of carcinogens. The contribution of glutathione S-transferases M1 and T1 genotypes to susceptibility to the risk of gastric cancer and their interaction with cigarette smoking are still unclear. The aim of this study was to determine whether there was any relationship between genetic polymorphisms of GSTT1 and GSTT1 and gastric cancer. METHODS: A population based case-control study was carried out in a high-risk area, Changle County, Fujian Province, China. The epidemiological data were collected by a standard questionnaire and blood samples were obtained from 95 incidence gastric cancer cases and 94 healthy controls. A polymerase chain reaction method was used to detect the presence or absence of the GSTT1 and GSTT1 genes in genomic DNA. Logistic regression model was employed in the data analysis. RESULTS: An increase in risk for gastric cancer was found among carriers of GSTT1 null genotype. The adjusted odds ratio (OR) was 2.63 95% Confidence Interval (95% CI) 1.17-5.88, after controlling for age, gender, cigarette smoking, alcohol drinking, and fish sauce intake. The frequency of GSTT1 null genotype in cancer cases (43.16%) was not significantly different from that in controls (50.00%). However, the risk for gastric cancer in those with GSTT1 null and GSTT1 non-null genotype was significantly higher than in those with both GSTT1 and GSTT1 non-null genotype (OR = 2.77, 95% CI 1.15-6.77). Compared with those subjects who never smoked and had normal GSTT1 genotype, ORs were 1.60 (95% CI:0.62-4.19) for never smokers with GSTT1 null type, 2.33 (95% CI 0.88-6.28) for smokers with normal GSTT1, and 8.06 (95% CI 2.83-23.67) for smokers with GSTT1 null type. CONCLUSIONS: GSTT1 gene polymorphisms may be associated with genetic susceptibility of stomach cancer and may modulate tobacco-related carcinogenesis of gastric cancer.展开更多
Demodex has been considered to be related with multiple skin disorders,but controversy persists.In this case-control study,a survey was conducted with 860 dermatosis patients aged 12 to 84 years in Xi'an,China to ...Demodex has been considered to be related with multiple skin disorders,but controversy persists.In this case-control study,a survey was conducted with 860 dermatosis patients aged 12 to 84 years in Xi'an,China to identify the association between facial dermatosis and Demodex.Amongst the patients,539 suffered from facial dermatosis and 321 suffered from non-facial dermatosis.Demodex mites were sampled and examined using the skin pressurization method.Multivariate regression analysis was applied to analyze the association between facial dermatosis and Demodex infestation,and to identify the risk factors of Demodex infestation.The results showed that total detection rate of Demodex was 43.0%.Patients aged above 30 years had higher odds of Demodex infestation than those under 30 years.Compared to patients with neutral skin,patients with mixed,oily,or dry skin were more likely to be infested with Demodex(odds ratios(ORs) were 2.5,2.4,and 1.6,respectively).Moreover,Demodex infestation was found to be statistically associated with rosacea(OR=8.1),steroid-induced dermatitis(OR=2.7),seborrheic dermatitis(OR=2.2),and primary irritation dermatitis(OR=2.1).In particular,ORs calculated from the severe infestation(≥5 mites/cm2) rate were significantly higher than those of the total rate.Therefore,we concluded that Demodex is associated with rosacea,steroid-induced dermatitis,seborrheic dermatitis,and primary irritation dermatitis.The rate of severe infestation is found to be more correlated with various dermatosis than the total infestation rate.The risk factors of Demodex infestation,age,and skin types were identified.Our study also suggested that good hygiene practice might reduce the chances of demodicosis and Demodex infestation.展开更多
AIM:To investigate the association of alcohol dose, duration of drinking and obesity with abnormal alcohol-related liver injury indicators, the prevalence of alcohol-related liver injury in the island population of Ch...AIM:To investigate the association of alcohol dose, duration of drinking and obesity with abnormal alcohol-related liver injury indicators, the prevalence of alcohol-related liver injury in the island population of China.METHODS:Randomized multistage stratified cluster sampling from the island population of China was used in the population-based case-control study. Then interview, physical examination, laboratory assessments and ultrasonography were done. RESULTS:Daily alcohol intake ≥ 20 g, duration of drinking ≥ 5 years and obesity were closely related to alcohol-related liver injury (P < 0.05). The odds-ratio (OR) (95% CI) was 1.965 (1.122-3.442), 3.412 (1.789-6.507) and 1.887 (1.261-2.824), respectively. The prevalence rate of alcohol-related liver injury in ≥ 20 g daily alcohol intake group and < 20 g daily alcohol intake group was 37.14% and 12.06%, respectively. The prevalence rate of alcohol-related liver injury in ≥ 5 years drinking group and < 5 years drinking group was 34.44% and 8.53%, respectively. No significant dose-response relation was found between daily alcohol intake and abnormal alcohol-related liver injury indicators as well as between duration of drinking and abnormal alcohol-related liver injury indicators. There was no significant difference in the prevalence of alcohol-related liver injury between beer drinking group and yellow rice wine drinking group, hard liquor drinking group, multiple drinking group.CONCLUSION:The risk threshold of daily alcohol intake is 20 g and duration of drinking inducing alcohol-related liver injury 5 years in the island population of China. Liver injury induced by obesity should be concerned.展开更多
BACKGROUND:Why 3.3%to 10%of all patients with hepatolithiasis develop intrahepatic cholangiocarcinoma(ICC)remains unknown.We carried out a hospital-based case-control study to identify risk factors for the development...BACKGROUND:Why 3.3%to 10%of all patients with hepatolithiasis develop intrahepatic cholangiocarcinoma(ICC)remains unknown.We carried out a hospital-based case-control study to identify risk factors for the development of ICC in patients with hepatolithiasis in China.METHODS:Eighty-seven patients with pathologically diagnosed hepatolithiasis associated with ICC and 228 with hepatolithiasis alone matched by sex,age(±2 years),hospital admittance and place of residence were interviewed during the period of 2000-2008.Odds ratios(OR)and 95%confidence intervals(CI)were calculated for each risk factor.RESULTS:Among the patients with hepatolithiasis associated with ICC,the mean age was 57.7 years and 61.0%were female Univariate analysis showed that the significant risk factors for ICC development in hepatolithiasis were smoking,family history of cancer,appendectomy during childhood(under age 20),and duration of symptoms>10 years.In multivariate stepwise logistic regression analysis,smoking(OR=1.931,95%CI:1.000-3.731),family history of cancer(OR=5.175,95%CI:1.216-22.022),and duration of symptoms>10 years(OR=2.34895%CI:1.394-3.952)were independent factors.CONCLUSION:Smoking,family history of cancer and duration of symptoms>10 years may be risk factors for ICC in patients with hepatolithiasis.展开更多
文摘BACKGROUND Proton pump inhibitors(PPIs)are among the most commonly prescribed medications globally.While concerns exist regarding their association with adverse infection-related outcomes,their impact on coronavirus disease 2019(COVID-19)severity remains uncertain.Emerging preclinical data suggest immunomodulatory and antiviral properties of PPIs,yet clinical evidence is conflicting.AIM To investigate whether chronic pre-hospital PPI use is associated with improved outcomes in patients hospitalized with COVID-19.METHODS We conducted a retrospective case-control study of adult inpatients with severe acute respiratory syndrome coronavirus 2 infection admitted to a racially and ethnically diverse communityhospital in Massachusetts from July 2021 to March 2022. Patients were stratified by documented pre-hospital PPIuse. The primary outcomes were intensive care unit (ICU) admission, need for invasive mechanical ventilation, andin-hospital mortality. Multivariable logistic regression was used to adjust for demographics, comorbidities, andtreatment variables. Significance was set at P < 0.05.RESULTSAmong 248 patients, 83 (33.4%) were on PPIs prior to hospitalization. Compared to non-users, PPI users hadsignificantly lower rates of ICU admission (13.3% vs 24.8%, P = 0.034), mechanical ventilation (13.3% vs 25.5%, P =0.027), and in-hospital mortality (6.0% vs 17.6%, P = 0.013). Multivariable analysis confirmed these associations:ICU admission [adjusted odds ratios (aOR): 0.462, 95%CI: 0.223–0.955], mechanical ventilation (aOR: 0.447, 95%CI:0.216–0.923), and mortality (aOR: 0.144, 95%CI: 0.031–0.677). Findings were consistent across demographic andcomorbidity strata.CONCLUSIONIn this diverse, real-world United States cohort, chronic pre-hospital PPI use was independently associated withlower odds of intensive care unit admission, mechanical ventilation, and mortality among COVID-19 inpatients.These findings highlight a potentially protective role of PPIs and support continued therapy in eligible patients.
基金Anhui Province’s Clinical Medical Research Transformation Special Initiative(Project No.:202204295107020016)。
文摘This case-control study evaluated the frequency of Glutathione S-transferase Mu 1(GSTM1)deletion and Glutathione S-transferase Alpha 1(GSTA1)mutation in chronic obstructive pulmonary disease(COPD)patients,whether they had concomitant lung squamous cell carcinoma(LSCC)or not,to assess their connection with cancer susceptibility.By means of multivariate logistic regression analysis,the GSTM1 null genotype serves as a significant standalone risk factor for LSCC,in addition to variables like age,smoking history,emphysema,body mass index(BMI),albumin level,and neutrophil-to-lymphocyte ratio(NLR).A predictive model incorporating these factors demonstrated superior discriminative ability compared to the established COPD Lung Cancer Screening Score(COPD-LUCSS).
文摘Randomized controlled trials(RCTs) are the gold standard in terms of study design, however, in the surgical setting conducting RCTs can often be unethical or logistically impossible. Case-control studies should become the major study design used in surgical research when RCTs are unable to be conducted and definitely replacing case series which offer little insight into surgical outcomes and disease processes.
基金supported by the China Postdoctoral Science Foundation(Grant No.2021M703366)Shenzhen Science and Technology Program(Grant No.KQTD20190929172835662).
文摘Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.
基金supported by“Dalian Maritime University Teaching Reform Research Fund 2022 Annual Project”(Fund No.XJG2022-96).
文摘This paper proposes an interdisciplinary talent training model that combines foreign language education with area studies.The model aims to cultivate international ocean affairs professionals with cross-cultural communication skills,in-depth regional and country knowledge,and practical expertise in ocean affairs.Additionally,the paper presents specific training pathways and policy recommendations for implementing this model.
文摘In modern society,the globalization of literary works is evident,with exceptional literary pieces from various countries spreading worldwide.Among these,children’s literature,due to the specificity of its target audience,imposes distinct requirements on children’s books,compelling translators to approach the text from a child’s perspective.“The Little Prince”has renowned both within and outside of China,and a careful reading of this work can provide us with much inspiration.To this end,the present study adopts the perspective of Gideon Toury’s Descriptive Translation Studies to conduct an in-depth analysis of the different English and Chinese translations in conjunction with the original French novel.This approach aims to better guide literary research and explores translation methods for children’s literature through the analysis of translation norms and rules.
基金supported by the Science and Technology Fund Project of Guizhou Health Commission(gzwkj2025-163)。
文摘Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth interviews with patients and families,anchored by Interactive Patient Par ticipation Theory,to analyze 4 high-severity adverse drug events(ADE)cases.Cases were purposively sampled from 8 communities in China's National Adverse Event Monitor Center(2018-2023).Semi-structured interviews explored patient perspectives,with data analyzed via thematic coding and triangulation against clinical records.Results:Five interconnected themes emerged:(1)erosion of trust,(2)communication breakdowns,(3)information asymmetry,(4)environmental inadequacies,and(5)technological alienation.Notably,75% of participants had≤high school education,and 50% used≥7 medications daily,compounding ADE risks.Conclusions:We considered elements mentioned by theory,exploring trust,communication,information,and suppor t as the root causes.In addition,we added“adaptability to new technology”as an impor tant and necessary component.It is impor tant and necessary to analyze typical adverse drug events from the perspectives of patients.
文摘Mindfulness would enhance university students’emotional well-being and study engagement.However,the role of affect(positive and negative emotions)and psychological resources(psychological capital)linking mindfulness to study engagement remain underexplored.This cross-sectional study surveyed 688 Chinese university students(females=413,mean age=20.3,SD=0.83),using validated self-report measures of mindfulness,positive and negative emotions,psychological capital,and study engagement.Structural equation modeling and bias-corrected bootstrap analyses(5000 resamples)revealed that mindfulness directly enhanced positive emotions,psychological capital,and study engagement,while reducing negative emotions.Positive emotions partially mediated the positive effect of mindfulness on psychological capital and study engagement.Negative emotions partially and negatively mediated only the mindfulness-psychological capital link.Psychological capital independently mediated the mindfulness-engagement relationship,and two sequential mediation pathways emerged:(a)mindfulness→positive emotions→psychological capital→higher study engagement and(b)mindfulness→reduced negative emotions→psychological capital→higher study engagement.Consistent with broaden-and-build(B&B)theory and Conservation of Resources(COR)theory,these findings suggest that mindfulness fosters study engagement primarily by promoting positive emotional experiences and strengthening psychological capital.By implication,university student support programs should employ mindfulness-based interventions to cultivate emotional and psychological resources for higher students’engagement and overall well-being.
文摘BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as expanding treatment indications,which affect the fair distribution of medical resources.There is limited research on ethical issues in the field of digestive endoscopy.AIM To investigate the level of ethical awareness among gastrointestinal endoscopy practitioners and analyze the ethical issues involved in gastrointestinal endoscopy technology.METHODS A questionnaire survey was performed to collect relevant data(gender,age,degree of education,professional title,personnel category,the level of understanding medical ethical principles,ethics training and its learning pathways)from gastrointestinal endoscopy practitioners at the Second Hospital of Dalian Medical University and Dalian Friendship Hospital,including licensed physicians and nurses(including trainees and graduate students).RESULTS The majority of gastrointestinal endoscopy practitioners have received training on ethics,but there is still considerable room for improvement in their ethical awareness.Different learning pathways may affect the mastery of ethical principles, and understanding of ethical principles is more easily achieved through hospital ethics institutions.CONCLUSIONTo address the ethical issues in gastrointestinal endoscopy technology, it is necessary to enhance the humanisticeducation of gastrointestinal endoscopy practitioners, incorporate ethical standards into the technology assessmentprocess, and establish a patient-centered diagnostic and treatment model to improve the ethical awareness of practitionersand achieve a balance between technology and ethics.
基金supported by the National Key Research and Development Program of China(2023YFA1508004)the National Natural Science Foundation of China(T2293692,22502164,92472203,22222903,52271229,22472074,22272069,22361132532,and 22021001)+6 种基金the Industry-University-Research Joint Innovation Project of Fujian Province(2023H6029)the Beijing National Laboratory for Molecular Sciences(BNLMS202305)the Scientific and Technological Project of Yunnan Precious Metals Laboratory(YPML-20240502063)the Liaoning Binhai Laboratory(Grant No.2024-05)the State Key Laboratory of Fine Chemicals,Dalian University of Technology(KF 2401)the Postdoctoral Fellowship Program of CPSF under Grant Number GZC20240897the China Postdoctoral Science Foundation(No.2025M770016).
文摘Escalating global energy demands and climate urgency necessitate advanced electrochemical energy conversion and storage technologies(EECSTs)like electrocatalysis and rechargeable batteries.Improving their performance relies on elucidating reaction mechanisms and structure-performance relationships via in situ studies.This review summarizes recent in situ studies of EECSTs through a variety of advanced characterization techniques aiming at mapping reaction pathways for the rational design of overall high-performance reaction systems.We outline the principles,capabilities,advantages,and limitations of various in situ techniques.Their applications in in situ studies of fuel cells,water/CO_(2)electrolysis,and lithium batteries are highlighted with representative examples.These studies enable dynamic tracking of chemical and structural evolution of overall reaction systems,including materials,intermediates,products,and surroundings during operation,providing insights critical to rational system design.Future advancements will involve integrating multimodal in situ/operando approaches with artificial intelligence to enable real-time monitoring at practical scales.Such integration promises precise mechanistic insights and robust structure-performance correlations,ultimately accelerating the development of high-performance EECSTs aligned with sustainability and market requirements.
文摘Objectives:In recent years,mental health has emerged as a pressing public health concern in China,driven by mounting societal pressures and fast-paced urban lifestyles.Physical activity,a well-established means of enhancing psychological well-being,has received growing scholarly and policy attention.This study uses panel data from the 2020 and 2022 waves of the China Family Panel Studies(CFPS)to examine the impact of exercise frequency on mental health(with indicators such as CESD-8 depression scores)among college students and young employees,thereby providing empirical support for targeted mental health interventions.Methods:This study examines the relationship between individual exercise frequency and mental health among college students and young employees,using panel data from the 2020 and 2022 waves of the China Family Panel Studies(CFPS),with the Chinese version of the 8-item Center for Epidemiologic Studies Depression Scale(CESD-8)depression scores,self-rated health,and life satisfaction as outcome variables.Specifically,this study tests three hypotheses:(H1)increased exercise frequency significantly reduces depression symptoms and enhances well-being;(H2)the effects of exercise vary by social roles,with stronger mental health benefits among employed individuals and those with lower education;and(H3)lifestyle factors such as smoking amount,sleep duration,and Body Mass Index(BMI)partially mediate the relationship between exercise and mental health.Employing a two-way fixed effects model,baseline results indicate that a one-unit increase in exercise frequency significantly reduces the CESD-8 score by 0.183 points.To address potential endogeneity and spurious regression concerns,an instrumental variable(IV)approach is further applied.The heterogeneity analysis differentiates between students and employed individuals.Results:Among students,the effects of exercise on mental health are not statistically significant,regardless of education level.In contrast,for the employed,exercise demonstrates a significant positive impact on mental health,with particularly pronounced effects among those with lower educational attainment.These findings underscore the importance of promoting exercise as part of comprehensive mental health strategies.Mediation analysis indicates that the beneficial effect of exercise on mental health is partially transmitted through reductions in adverse health behaviors,especially smoking.Conclusions:Policymakers should integrate physical activity promotion into health interventions,prioritizing vulnerable groups to enhance psychological resilience and foster inclusive,health-oriented development.
文摘AIM:To investigate the potential causal associations between 41 inflammatory cytokines and myopia using a two-sample Mendelian randomization(MR)approach.METHODS:Publicly available genome-wide association study(GWAS)datasets were utilized for this two-sample MR analysis.Inflammatory cytokine-related GWAS data were extracted from The University of Bristol’s Research Data Repository,and myopia-related GWAS data were obtained from the FinnGen project.Single nucleotide polymorphisms(SNPs)associated with inflammatory cytokines were systematically selected as instrumental variables(IVs)based on three rigorous criteria:relevance,independence,and exclusion of pleiotropy.Five MR methods were employed for causal inference:the inverse-variance weighted(IVW)method as the primary analysis,supplemented by MREgger regression,weighted median estimator,simple mode,and weighted mode approaches.Sensitivity analyses were performed to evaluate the robustness of the causal estimates.RESULTS:A total of 773 myopia-associated SNPs were identified.MR analysis revealed that higher levels of macrophage inflammatory protein 1-α(MIP-1α)were associated with a 17%reduced risk of myopia[odds ratio(OR)=0.83;95%confidence interval(CI):0.69-0.99;P<0.05].In contrast,elevated levels of eotaxin(OR=1.26;95%CI:1.07-1.47;P<0.01),stromal cell-derived factor-1α(SDF-1α;OR=1.68;95%CI:1.08-2.62;P<0.05),and interleukin-2 receptor subunit alpha(IL-2Rα;OR=1.25;95%CI:1.01-1.53;P<0.05)were significantly associated with an increased risk of myopia.Sensitivity analyses confirmed the reliability of these results.CONCLUSION:This study provides evidence supporting a causal relationship between specific inflammatory cytokines and myopia.MIP-1αmay act as a protective factor against myopia,while eotaxin,SDF-1α,and IL-2Rαare potential risk factors for myopia.These findings emphasize the critical role of inflammatory pathways in the pathogenesis of myopia,offering novel insights for the development of preventive and therapeutic strategies for myopia.
文摘Background:Despite highly effective vaccines against SARS-CoV-2,COVID-19 vaccine hesitancy persisted in some populations in England during the pandemic,with rates and motivations for hesitancy varying by demographic group.Addressing the drivers of vaccine hesitancy through targeted interventions in hesitant groups is a public health priority for better and more rapid control of disease spread.We aimed to characterise the determinants and subtypes of vaccine hesitancy and identify more persistent forms of hesitancy via analysis of vaccine uptake in a large cross-sectional cohort with linked National Health Service(NHS)data.
基金financial support fromthe Chung Shan Medical University Hospital,Taiwan(CSH-2022-A-009).
文摘Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and whether this association differs by baseline body-mass index(BMI).Methods:This retrospective cohort study used electronic health records from the TriNetX U.S.research network.Adults aged 20 years or older diagnosed with T2DM between 2016 and 2024 were included if they received any hypoglycemic agents within 3 months before and after diagnosis.Following 1:1 propensity score matching,both the GLP-1 RA user and non-user groups included 183,264 patients.The study outcome was defined as a diagnosis of malignant neoplasms.Hazard ratios(HRs)for overall and site-specific cancer risk were estimated using Cox proportional hazards models.Kaplan–Meier analysis and stratified analysis by BMI were performed.Results:Early GLP-1 RA use demonstrated a modest but significant association with reduced overall cancer risk(HR 0.93;95%CI:0.90–0.96).Reduced risks were noted for cancers of the digestive(HR 0.81),respiratory(HR 0.66),and female genital(HR 0.87)systems.In stratified analysis,benefits were more pronounced in patients with BMI≥30,particularly for pancreatic and colorectal cancers.Conclusion:Early initiation of GLP-1 receptor agonists in patients with diagnosed T2DM was associated with a modest reduction in overall cancer risk,particularly among individuals with obesity.These findings highlight the dual metabolic and oncologic value of prompt GLP-1 RA therapy.
文摘Through the questionnaire survey and comparative studies on tourist satisfaction of tourism services among three world heritage sites,i.e.Huangshan Mountain,Lushan Mountain and Wuyi Mountain,this study pointed out the problems in tourism services of three scenic areas and then put forward relevant countermeasures for the management of scenic areas.
基金Natural Science Foundation of Fujian Province,China,No.C001009
文摘AIM: Glutathione S-transferases (GSTs) are involved in the detoxification of many potential carcinogens and appear to play a critical role in the protection from the effects of carcinogens. The contribution of glutathione S-transferases M1 and T1 genotypes to susceptibility to the risk of gastric cancer and their interaction with cigarette smoking are still unclear. The aim of this study was to determine whether there was any relationship between genetic polymorphisms of GSTT1 and GSTT1 and gastric cancer. METHODS: A population based case-control study was carried out in a high-risk area, Changle County, Fujian Province, China. The epidemiological data were collected by a standard questionnaire and blood samples were obtained from 95 incidence gastric cancer cases and 94 healthy controls. A polymerase chain reaction method was used to detect the presence or absence of the GSTT1 and GSTT1 genes in genomic DNA. Logistic regression model was employed in the data analysis. RESULTS: An increase in risk for gastric cancer was found among carriers of GSTT1 null genotype. The adjusted odds ratio (OR) was 2.63 95% Confidence Interval (95% CI) 1.17-5.88, after controlling for age, gender, cigarette smoking, alcohol drinking, and fish sauce intake. The frequency of GSTT1 null genotype in cancer cases (43.16%) was not significantly different from that in controls (50.00%). However, the risk for gastric cancer in those with GSTT1 null and GSTT1 non-null genotype was significantly higher than in those with both GSTT1 and GSTT1 non-null genotype (OR = 2.77, 95% CI 1.15-6.77). Compared with those subjects who never smoked and had normal GSTT1 genotype, ORs were 1.60 (95% CI:0.62-4.19) for never smokers with GSTT1 null type, 2.33 (95% CI 0.88-6.28) for smokers with normal GSTT1, and 8.06 (95% CI 2.83-23.67) for smokers with GSTT1 null type. CONCLUSIONS: GSTT1 gene polymorphisms may be associated with genetic susceptibility of stomach cancer and may modulate tobacco-related carcinogenesis of gastric cancer.
基金Project supported by the National Natural Science Foundation of China (No. 30872199)the Natural Science Foundation of Shaanxi Province (No. 2006C247),China
文摘Demodex has been considered to be related with multiple skin disorders,but controversy persists.In this case-control study,a survey was conducted with 860 dermatosis patients aged 12 to 84 years in Xi'an,China to identify the association between facial dermatosis and Demodex.Amongst the patients,539 suffered from facial dermatosis and 321 suffered from non-facial dermatosis.Demodex mites were sampled and examined using the skin pressurization method.Multivariate regression analysis was applied to analyze the association between facial dermatosis and Demodex infestation,and to identify the risk factors of Demodex infestation.The results showed that total detection rate of Demodex was 43.0%.Patients aged above 30 years had higher odds of Demodex infestation than those under 30 years.Compared to patients with neutral skin,patients with mixed,oily,or dry skin were more likely to be infested with Demodex(odds ratios(ORs) were 2.5,2.4,and 1.6,respectively).Moreover,Demodex infestation was found to be statistically associated with rosacea(OR=8.1),steroid-induced dermatitis(OR=2.7),seborrheic dermatitis(OR=2.2),and primary irritation dermatitis(OR=2.1).In particular,ORs calculated from the severe infestation(≥5 mites/cm2) rate were significantly higher than those of the total rate.Therefore,we concluded that Demodex is associated with rosacea,steroid-induced dermatitis,seborrheic dermatitis,and primary irritation dermatitis.The rate of severe infestation is found to be more correlated with various dermatosis than the total infestation rate.The risk factors of Demodex infestation,age,and skin types were identified.Our study also suggested that good hygiene practice might reduce the chances of demodicosis and Demodex infestation.
文摘AIM:To investigate the association of alcohol dose, duration of drinking and obesity with abnormal alcohol-related liver injury indicators, the prevalence of alcohol-related liver injury in the island population of China.METHODS:Randomized multistage stratified cluster sampling from the island population of China was used in the population-based case-control study. Then interview, physical examination, laboratory assessments and ultrasonography were done. RESULTS:Daily alcohol intake ≥ 20 g, duration of drinking ≥ 5 years and obesity were closely related to alcohol-related liver injury (P < 0.05). The odds-ratio (OR) (95% CI) was 1.965 (1.122-3.442), 3.412 (1.789-6.507) and 1.887 (1.261-2.824), respectively. The prevalence rate of alcohol-related liver injury in ≥ 20 g daily alcohol intake group and < 20 g daily alcohol intake group was 37.14% and 12.06%, respectively. The prevalence rate of alcohol-related liver injury in ≥ 5 years drinking group and < 5 years drinking group was 34.44% and 8.53%, respectively. No significant dose-response relation was found between daily alcohol intake and abnormal alcohol-related liver injury indicators as well as between duration of drinking and abnormal alcohol-related liver injury indicators. There was no significant difference in the prevalence of alcohol-related liver injury between beer drinking group and yellow rice wine drinking group, hard liquor drinking group, multiple drinking group.CONCLUSION:The risk threshold of daily alcohol intake is 20 g and duration of drinking inducing alcohol-related liver injury 5 years in the island population of China. Liver injury induced by obesity should be concerned.
文摘BACKGROUND:Why 3.3%to 10%of all patients with hepatolithiasis develop intrahepatic cholangiocarcinoma(ICC)remains unknown.We carried out a hospital-based case-control study to identify risk factors for the development of ICC in patients with hepatolithiasis in China.METHODS:Eighty-seven patients with pathologically diagnosed hepatolithiasis associated with ICC and 228 with hepatolithiasis alone matched by sex,age(±2 years),hospital admittance and place of residence were interviewed during the period of 2000-2008.Odds ratios(OR)and 95%confidence intervals(CI)were calculated for each risk factor.RESULTS:Among the patients with hepatolithiasis associated with ICC,the mean age was 57.7 years and 61.0%were female Univariate analysis showed that the significant risk factors for ICC development in hepatolithiasis were smoking,family history of cancer,appendectomy during childhood(under age 20),and duration of symptoms>10 years.In multivariate stepwise logistic regression analysis,smoking(OR=1.931,95%CI:1.000-3.731),family history of cancer(OR=5.175,95%CI:1.216-22.022),and duration of symptoms>10 years(OR=2.34895%CI:1.394-3.952)were independent factors.CONCLUSION:Smoking,family history of cancer and duration of symptoms>10 years may be risk factors for ICC in patients with hepatolithiasis.
