Understanding crash contributing factors is essential in safety management and improvement. These factors drive investment decisions, policies, regulations, and other safety-related initiatives. This paper analyzes fa...Understanding crash contributing factors is essential in safety management and improvement. These factors drive investment decisions, policies, regulations, and other safety-related initiatives. This paper analyzes factors that contribute to crash occurrence based on two national datasets in the United States (CISS and NASS-CDS) for the years 2017-2022 and 2010-2015, respectively. Three taxonomies were applied to enhance understanding of the various crash contributing factors. These taxonomies were developed based on previous research and practice and involved different groupings of human factors, vehicle factors, and roadway and environmental factors. Statistics for grouping the different types of factors and statistics for specific factors are provided. The results indicate that human factors are present in over 95% of crashes, roadway and environmental factors are present in over 45% of crashes, and vehicle factors are present in less than 2% of crashes. Regarding factors related to human error and vehicle maintenance, speeding is involved in over 25% of crashes, distraction is involved in over 20% of crashes, alcohol and drugs are involved in over 9% of crashes, and vehicle maintenance is involved in approximately 0.45% of crashes. Approximately 4.4% of crashes involve a driver who “looked but did not see.” Weather is involved in over 13% of crashes. Conclusions: The findings indicate that, consistent with previous research, human factors or human error are present in around 95% of crashes. Infrastructure and environmental factors contribute to about 45% of crashes. Vehicle factors contribute to only 1.67% - 1.71% of crashes. The results from this study could potentially be used to inform future safety management and improvement activities, including policy-making, regulation development, safe systems and systemic safety approaches to safety management, and other engineering, education, emergency response, enforcement, evaluation, and encouragement activities. The findings could also be used in the development of future Driver Assistance Technologies (DAT) systems and in enhancing existing technologies.展开更多
BACKGROUND Studies investigating diagnostic delays and their effects on patients with alcoholic cirrhosis.AIM To investigate the current status and associated factors influencing diagnostic delays in 401 patients with...BACKGROUND Studies investigating diagnostic delays and their effects on patients with alcoholic cirrhosis.AIM To investigate the current status and associated factors influencing diagnostic delays in 401 patients with alcoholic cirrhosis.METHODS A cross-sectional analysis was conducted at a tertiary hospital in China from June 2020 to December 2023.Data were collected through telephone follow-ups and questionnaires.The Wilcoxon and Kruskal-Wallis H tests were used to compare diagnostic delays across various characteristics.Multivariate linear regression was employed to identify factors associated with diagnostic delays.RESULTS The median diagnostic delay was 5 months,with an interquartile range of 2-11 months.The proportions of patients with alcoholic cirrhosis who initially visited tertiary,secondary,and primary hospitals were 38.9%,37.91%,and 23.19%,respectively.Furthermore,the rates of patients undergoing liver computed tomography(CT)during their first visit at tertiary,secondary,and primary hospitals were 92.95%,13.82%,and 1.08%,respectively(P<0.001).Significant differences were observed in diagnostic delay-related characteristics,including residence,resident type,initial diagnosis,medical insurance,liver CT,and liver ultrasound during the first visit,age,years of education,family size,marital status,annual family income,years of drinking,daily alcohol consumption,and type of alcohol consumed(P<0.01).Furthermore,diagnostic delays were variably associated with daily alcohol consumption and other characteristics(i.e.residence,years of drinking,medical insurance,years of education,annual family income,liver CT and ultrasound during the first visit).Significant predictors of diagnostic delay identified on multivariate linear regression analysis included years of education,daily alcohol consumption,annual family income and blood ammonia levels(P<0.01).Patients with alcoholic cirrhosis experience varying degrees of diagnostic delays,necessitating interventions targeting potential contributing factors.CONCLUSION Our study indicates that patients with alcoholic cirrhosis may experience varying degrees of diagnostic delay.Interventions targeting potential factors contributing to diagnostic delay are necessary.展开更多
Spinal cord injury represents a severe form of central nervous system trauma for which effective treatments remain limited.Microglia is the resident immune cells of the central nervous system,play a critical role in s...Spinal cord injury represents a severe form of central nervous system trauma for which effective treatments remain limited.Microglia is the resident immune cells of the central nervous system,play a critical role in spinal cord injury.Previous studies have shown that microglia can promote neuronal survival by phagocytosing dead cells and debris and by releasing neuroprotective and anti-inflammatory factors.However,excessive activation of microglia can lead to persistent inflammation and contribute to the formation of glial scars,which hinder axonal regeneration.Despite this,the precise role and mechanisms of microglia during the acute phase of spinal cord injury remain controversial and poorly understood.To elucidate the role of microglia in spinal cord injury,we employed the colony-stimulating factor 1 receptor inhibitor PLX5622 to deplete microglia.We observed that sustained depletion of microglia resulted in an expansion of the lesion area,downregulation of brain-derived neurotrophic factor,and impaired functional recovery after spinal cord injury.Next,we generated a transgenic mouse line with conditional overexpression of brain-derived neurotrophic factor specifically in microglia.We found that brain-derived neurotrophic factor overexpression in microglia increased angiogenesis and blood flow following spinal cord injury and facilitated the recovery of hindlimb motor function.Additionally,brain-derived neurotrophic factor overexpression in microglia reduced inflammation and neuronal apoptosis during the acute phase of spinal cord injury.Furthermore,through using specific transgenic mouse lines,TMEM119,and the colony-stimulating factor 1 receptor inhibitor PLX73086,we demonstrated that the neuroprotective effects were predominantly due to brain-derived neurotrophic factor overexpression in microglia rather than macrophages.In conclusion,our findings suggest the critical role of microglia in the formation of protective glial scars.Depleting microglia is detrimental to recovery of spinal cord injury,whereas targeting brain-derived neurotrophic factor overexpression in microglia represents a promising and novel therapeutic strategy to enhance motor function recovery in patients with spinal cord injury.展开更多
Objective:To analyze the risk factors associated with multidrug-resistant tuberculosis(MDR-TB)as a first national survey in Indonesia.Methods:This national coverage cross-sectional study was conducted from 2017 to 201...Objective:To analyze the risk factors associated with multidrug-resistant tuberculosis(MDR-TB)as a first national survey in Indonesia.Methods:This national coverage cross-sectional study was conducted from 2017 to 2018.The study subjects were selected using a multi-stage probability random sampling method.MDR-TB is tuberculosis caused by bacteria resistant to at least isoniazid and rifampicin.The dependent variable was MDR-TB.Independent variables included age,sex,education,employment status,place of residence,history of living with TB patients,and the number of household members.Univariate and multivariate logistic regression models were used to analyze the risk factors associated with MDR-TB.All the data were analyzed using STATA V.14.0(Stata Corp LLC,College Station,TX).Results:This study found the MDR rate was 109/3234(3.4%)among positive pulmonary TB patients.More than twice as many patients had MDR re-treatment(74/3234,2.3%),compared to 35/3234(1.1%)who had new TB diagnoses or were getting initial treatment.After adjusting for employment status,individuals with a prior history of tuberculosis treatment were found to have significantly higher odds of developing MDR-TB,with an odds ratio of 7.22(95%CI 3.87-13.44).Conclusions:Increasing attention should be paid to these patients to prevent MDR-TB,and MDR-TB transmission is an urgent challenge for controlling TB worldwide.Early detection of MDR-TB is a critical part of TB control programs.展开更多
Autism spectrum disorder is a mental neurodevelopmental condition characterized by social deficits and repetitive behavior,and its development is influenced by genetic and environmental factors.Furthermore,an importan...Autism spectrum disorder is a mental neurodevelopmental condition characterized by social deficits and repetitive behavior,and its development is influenced by genetic and environmental factors.Furthermore,an important factor in etiology is the health status of the mother during pregnancy.Maternal health can critically affect the development of the offspring’s nervous system,including the central nervous system and enteric nervous system.Unfavorable maternal health can disrupt the normal development of the offspring’s nervous system in various ways,such as changes in microbiota composition.As one of the common comorbidities of autism spectrum disorder,no consistent conclusion has been drawn on how poor maternal health affects enteric nervous system and cen-tral nervous system development in offspring.From the perspective of maternal health,this review discusses how maternal status affects the gastrointestinal health of offspring and the development of mental systems to raise public awar-eness of maternal health and provide a new idea for eugenics and childbearing.展开更多
This systematic review synthesizes empirical research on external risk factors for adolescent smartphone addiction.Scopus and Web of Science were searched for English peer-reviewed empirical articles from 2008 onward;...This systematic review synthesizes empirical research on external risk factors for adolescent smartphone addiction.Scopus and Web of Science were searched for English peer-reviewed empirical articles from 2008 onward;28 met inclusion criteria(excluding non-adolescents,generic internet addiction,non-empirical work,or non-English).Thematic synthesis organized findings into three external risk domains—family,school,and peers—considering cultural/contextual mechanisms.Family dynamics(parental phubbing,harsh parenting,dysfunction),school stressors,and adverse peer relationships were identified as accumulating,direct and indirect contributors to smartphone addiction.These operate within a techno-ecological framework,where digital technologies amplify vulnerabilities and create new pathways for maladaptive use.Evidence favors an ecological,multi-level perspective.Future research should use longitudinal designs,standardize measures across cultures,and examine understudied regions—especially Africa—to guide culturally sensitive interventions.展开更多
BACKGROUND Ischemic stroke is one of the leading global causes of disability and death.Despite advances in modern medical technology that improve acute treatment and rehabilitation measures,post-stroke anxiety and dep...BACKGROUND Ischemic stroke is one of the leading global causes of disability and death.Despite advances in modern medical technology that improve acute treatment and rehabilitation measures,post-stroke anxiety and depression(PSD)do not receive sufficient attention.AIM To systematically evaluate risk factors and early identification markers for PSD for more precise screening and intervention strategies in clinical practice.METHODS This retrospective study analyzed clinical data from 112 patients with ischemic stroke admitted between January 2022 and December 2024.Based on assessments using the Hamilton Rating Scale for Anxiety(HAMA)and Hamilton Rating Scale for Depression(HAMD)at 2 weeks(±3 days)post-stroke,patients were classified into the PSD group(HAMA≥7 and/or HAMD≥7)and the non-PSD group(HAMA<7 and HAMD<7).Observation indicators included psychological assessment,demographic and clinical characteristics,stroke-related clinical indicators,neuroimaging assessments,and laboratory biomarkers.Multivariate logistic regression analysis was used to identify independent risk factors for PSD,and receiver operating characteristic curve analysis was used to evaluate the diagnostic value of potential biomarkers.RESULTS Of the 112 patients,46(41.1%)were diagnosed with PSD.Multivariate analysis identified five independent risk factors:Female gender[Odds ratio(OR)=2.32,95%confidence interval(CI):1.56-3.45],history of mental disorders prior to stroke(OR=3.17,95%CI:1.89-5.32),infarct location in the frontal lobe or limbic system(OR=2.86,95%CI:1.73-4.71),stroke severity with National Institutes of Health Stroke Scale≥8 at admission(OR=2.54,95%CI:1.62-3.99),and low social support(Social Support Rating Scale<35,OR=2.18,95%CI:1.42-3.36).Subgroup analysis showed that depression patients more commonly had left hemisphere lesions(68.4%vs 45.2%),while anxiety patients more frequently presented with right hemisphere lesions(59.5%vs 39.5%).The PSD group exhibited larger infarct volumes(8.7 cm^(3) vs 5.3 cm^(3)),more severe white matter hyperintensities,and more pronounced frontal lobe atrophy.Analysis of inflammatory markers showed significantly elevated levels of interleukin-6(7.8 pg/mL vs 4.5 pg/mL)and tumor necrosis factor-alpha(15.6 pg/mL vs 9.8 pg/mL)in the PSD group,while hypothalamicpituitary-adrenal axis function assessment revealed higher cortisol levels(386.5±92.3 nmol/L vs 328.7±75.6 nmol/L)and flattened diurnal rhythm in the PSD group.CONCLUSION PSD is a complex neuropsychiatric consequence of stroke involving disruption of the frontal-limbic circuitry,neuroinflammatory responses,and dysfunction of the hypothalamic-pituitary-adrenal axis.展开更多
Strokes include both ischemic stroke,which is mediated by a blockade or reduction in the blood supply to the brain,and hemorrhagic stroke,which comprises intracerebral hemorrhage and subarachnoid hemorrhage and is cha...Strokes include both ischemic stroke,which is mediated by a blockade or reduction in the blood supply to the brain,and hemorrhagic stroke,which comprises intracerebral hemorrhage and subarachnoid hemorrhage and is characterized by bleeding within the brain.Stroke is a lifethreatening cerebrovascular condition characterized by intricate pathophysiological mechanisms,including oxidative stress,inflammation,mitochondrial dysfunction,and neuronal injury.Critical transcription factors,such as nuclear factor erythroid 2-related factor 2 and nuclear factor kappa B,play central roles in the progression of stroke.Nuclear factor erythroid 2-related factor 2 is sensitive to changes in the cellular redox status and is crucial in protecting cells against oxidative damage,inflammatory responses,and cytotoxic agents.It plays a significant role in post-stroke neuroprotection and repair by influencing mitochondrial function,endoplasmic reticulum stress,and lysosomal activity and regulating metabolic pathways and cytokine expression.Conversely,nuclear factor-kappa B is closely associated with mitochondrial dysfunction,the generation of reactive oxygen species,oxidative stress exacerbation,and inflammation.Nuclear factor-kappa B contributes to neuronal injury,apoptosis,and immune responses following stroke by modulating cell adhesion molecules and inflammatory mediators.The interplay between these pathways,potentially involving crosstalk among various organelles,significantly influences stroke pathophysiology.Advancements in single-cell sequencing and spatial transcriptomics have greatly improved our understanding of stroke pathogenesis and offer new opportunities for the development of targeted,individualized,cell typespecific treatments.In this review,we discuss the mechanisms underlying the involvement of nuclear factor erythroid 2-related factor 2 and nuclear factor-kappa B in both ischemic and hemorrhagic stroke,with an emphasis on their roles in oxidative stress,inflammation,and neuroprotection.展开更多
BACKGROUND:Acute pain is a sudden experience secondary to injuries and varies in perception among individuals.In trauma patients,it can negatively aff ect respiratory function,immune response,and wound healing,making ...BACKGROUND:Acute pain is a sudden experience secondary to injuries and varies in perception among individuals.In trauma patients,it can negatively aff ect respiratory function,immune response,and wound healing,making it a signifi cant public health concern.This study is to determine the prevalence and factors associated with acute pain among emergency trauma patients.METHODS:A multicenter cross-sectional study was conducted.Data were collected via interviewer-administered questionnaires and patient chart review.The data were analyzed via the statistical package for social science version 25.Bivariable and multivariable logistic regression analyses were used.Variables with a P-value<0.05 were considered statistically signifi cant.RESULTS:A total of 397 patients were included in the study,for a response rate of 96.8%.The prevalence of pain during admission was 91.9%(95%confi dence intervals[95%CIs]:88.8%-94.4%).Blunt trauma(adjusted odds ratio[aOR]=2.82;95%CI:1.23-6.45),analgesia before admission to the emergency department(aOR=2.71;95%CI:1.16-6.36),documentation of pain severity in the chart(aOR=2.71;95%CI:1.16-6.36),analgesia provided within two hours after admission(aOR=7.60;95%CI:2.79-20.68),use of non-pharmacological pain management methods(aOR=3.09;95%CI:1.35-7.08)and availability of analgesia(aOR=3.95;95%CI:1.36-11.43)were associated with acute pain experience.CONCLUSION:The prevalence of acute pain among emergency trauma patients was high in the study area.Analgesia should be administered prior to admission,and non-pharmacological pain management should be implemented.Moreover,training on pain assessment and management should be provided for healthcare providers in the emergency department.展开更多
Nerve trauma commonly results in chronic neuropathic pain. This is by triggering the release of proinflammatory mediators from local and invading cells that induce inflammation and nociceptive neuron hyperexcitability...Nerve trauma commonly results in chronic neuropathic pain. This is by triggering the release of proinflammatory mediators from local and invading cells that induce inflammation and nociceptive neuron hyperexcitability. Even without apparent inflammation, injury sites are associated with increased inflammatory markers. This review focuses on how it might be possible to reduce neuropathic pain by reducing inflammation. Physiologically, pain is resolved by a combination of the out-migration of pro-inflammatory cells from the injury site, the down-regulation of the genes underlying the inflammation, up-regulating genes for anti-inflammatory mediators, and reducing nociceptive neuron hyperexcitability. While various techniques reduce chronic neuropathic pain, the best are effective on < 50% of patients, no technique reliably or permanently eliminates neuropathic pain. This is because most techniques are predominantly aimed at reducing pain, not inflammation. In addition, while single factors reduce pain, increasing evidence indicates significant and longer-lasting pain relief requires multiple factors acting simultaneously. Therefore, it is not surprising that extensive data indicate that the application of platelet-rich plasma provides more significant and longer-lasting pain suppression than other techniques, although its analgesia is neither complete nor permanent. However, several case reports indicate that platelet-rich plasma can induce permanent neuropathic pain elimination when the platelet concentration is significantly increased and is applied to longer nerve lengths. This review examines the primary triggers of the development and maintenance of neuropathic pain and techniques that reduce chronic neuropathic pain. The application of plateletrich plasma holds great promise for providing complete and permanent chronic neuropathic pain elimination.展开更多
BACKGROUND Post-transplant tertiary hyperparathyroidism(PT-tHPT)is a well-recognized complication following kidney transplantation,characterized by persistent excessive secretion of parathyroid hormone(PTH)despite imp...BACKGROUND Post-transplant tertiary hyperparathyroidism(PT-tHPT)is a well-recognized complication following kidney transplantation,characterized by persistent excessive secretion of parathyroid hormone(PTH)despite improved renal function.It is potentially associated with an increased risk of cardiovascular events,renal osteodystrophy,pathologic fractures,graft loss,and mortality.AIM To evaluate the incidence,risk factors,and outcomes of PT-tHPT amongst kidney transplant recipients.METHODS A total of 887 transplant recipients who underwent transplantation between 2000 and 2020 were evaluated.Univariable and multivariable logistic regression was performed to determine the predictors of tertiary hyperparathyroidism.Graft and recipient outcomes were assessed using multivariable Cox regression.A separate multivariable Cox regression was performed to determine the effect of treatment strategies on outcomes.RESULTS PT-tHPT,defined as elevated PTH(>65 ng/L)and persistent hypercalcemia(>2.60 mmol/L),was diagnosed in 14%of recipients.Risk factors for PT-tHPT included older age[odds ratio(OR)=1.36,P<0.001],Asian ethnicity(OR=0.33,P=0.006),total ischemia time(OR=1.03,P=0.048 per hour),pre-transplant serum calcium(OR=1.38,P<0.001)per decile increase,pre-transplant PTH level(OR=1.31,P<0.001)per decile increase,longer dialysis duration(OR=1.12,P=0.002)per year,history of acute rejection(OR=2.37,P=0.012),and slope of estimated glomerular filtration rate change(OR=0.91,P=0.001).There were a 3.4-fold higher risk of death-censored graft loss and a 1.9-fold greater risk of recipient death with PT-tHPT.The three treatment strategies of conservative management,calcimimetic and parathyroidectomy did not significantly change the graft or patient outcome.CONCLUSION Pretransplant elevated calcium and PTH levels,older age and dialysis duration are associated with PT-tHPT.While PT-tHPT significantly affects graft and recipient survival,the treatment strategies did not affect survival.展开更多
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
Landslides pose a formidable natural hazard across the Qinghai-Tibet Plateau(QTP),endangering both ecosystems and human life.Identifying the driving factors behind landslides and accurately assessing susceptibility ar...Landslides pose a formidable natural hazard across the Qinghai-Tibet Plateau(QTP),endangering both ecosystems and human life.Identifying the driving factors behind landslides and accurately assessing susceptibility are key to mitigating disaster risk.This study integrated multi-source historical landslide data with 15 predictive factors and used several machine learning models—Random Forest(RF),Gradient Boosting Regression Trees(GBRT),Extreme Gradient Boosting(XGBoost),and Categorical Boosting(CatBoost)—to generate susceptibility maps.The Shapley additive explanation(SHAP)method was applied to quantify factor importance and explore their nonlinear effects.The results showed that:(1)CatBoost was the best-performing model(CA=0.938,AUC=0.980)in assessing landslide susceptibility,with altitude emerging as the most significant factor,followed by distance to roads and earthquake sites,precipitation,and slope;(2)the SHAP method revealed critical nonlinear thresholds,demonstrating that historical landslides were concentrated at mid-altitudes(1400-4000 m)and decreased markedly above 4000 m,with a parallel reduction in probability beyond 700 m from roads;and(3)landslide-prone areas,comprising 13%of the QTP,were concentrated in the southeastern and northeastern parts of the plateau.By integrating machine learning and SHAP analysis,this study revealed landslide hazard-prone areas and their driving factors,providing insights to support disaster management strategies and sustainable regional planning.展开更多
Objectives This study aimed to explore the lagged and cumulative effects of risk factors on disability in older adults using distributed lag non-linear models(DLNMs).Methods We utilized data from the China Health and ...Objectives This study aimed to explore the lagged and cumulative effects of risk factors on disability in older adults using distributed lag non-linear models(DLNMs).Methods We utilized data from the China Health and Retirement Longitudinal Study(CHARLS).After feature selection via Elastic Net Regularization,we applied DLNMs to evaluate the lagged effects of risk factors.Disability was defined as the presence of any difficulties in basic activities of daily living(BADL).The cumulative relative risk(CRR)was calculated by summing the lag-specific risk estimates,representing the cumulative disability risk over the specified lag period.Effect modifications and sensitivity analyses were also performed.Results This study included a total of 2,318 participants.Early-phase lag factors,such as the difficulty in stooping(CRR=3.58;95%CI:2.31-5.55;P<0.001)and walking(CRR=2.77;95%CI:1.39-5.55;P<0.001),exerted the strongest effects immediately upon occurrence.Mid-phase lag factors,such as arthritis(CRR=1.51;95%CI:1.10-2.06;P=0.001),showed a resurgence in disability risk within 2-3 years.Late-phase lag factors,including depressive symptoms(CRR=2.38;95%CI:1.30-4.35;P<0.001)and elevated systolic blood pressure(CRR=1.64;95%CI:1.06-2.79;P=0.02),exhibited significant long-term cumulative risks.Conversely,grip strength(CRR=0.80;95%CI:0.54-0.95;P=0.02)and social participation(CRR=0.89;95%CI:0.73-0.99;P=0.04)were significant protective factors.Conclusions The findings underscore the importance of tailored interventions that account for various lag characteristics of different factors to effectively mitigate disability risk.Future studies should explore the underlying biological and sociological mechanisms of these lagged effects,identify intervention strategies that target risk factors with different lagged patterns,and evaluate their effectiveness.展开更多
Objective:Based on the theory of“Taiyang governs tendons”,to explore the effect of acupuncture at points of the Bladder Meridian of Foot-Taiyang on the expression of serum inflammatory factors in rabbit models of ce...Objective:Based on the theory of“Taiyang governs tendons”,to explore the effect of acupuncture at points of the Bladder Meridian of Foot-Taiyang on the expression of serum inflammatory factors in rabbit models of cervical spondylosis.Methods:Thirty New Zealand white rabbits were randomly divided into a blank group,a model group,and a treatment group,with 10 rabbits in each group.The models of cervical spondylosis in the model group and treatment group were established by long-term head-down flexion combined with cold-damp stimulation.After modeling,the treatment group received acupuncture at three points(Kunlun,Weizhong,and Feishu)on the Bladder Meridian of Foot-Taiyang,once a day for 20 minutes each time,for 14 consecutive days;the model group and blank group received no therapeutic intervention.After the intervention,cardiac blood was collected from all rabbits to detect the expression levels of serum inflammatory factors IL-6,TNF-α,and IL-1β.Meanwhile,cervical muscle tissue was collected,stained with HE,and the morphological changes of the posterior cervical muscle tissue in each group were observed under an optical microscope.Results:After modeling,the levels of inflammatory factors in the serum of rabbits in the model group and treatment group were significantly increased compared with those before modeling,with a statistically significant difference(p<0.01).After intervention,the serum inflammatory factors in the treatment group decreased significantly compared with those in the model group,and the difference was statistically significant(p<0.01).Conclusion:Acupuncture at points of the Bladder Meridian of Foot-Taiyang in rabbit models of cervical spondylosis can reduce the serum levels of inflammatory factors TNF-α,IL-1β,and IL-6.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
Epimedium is commonly used to treat bone injury and kidney disease,with prenylated flavonol glycosides(PFGs)as its active ingredients.It has attracted much attention due to prominent healthcare and therapeutic effects...Epimedium is commonly used to treat bone injury and kidney disease,with prenylated flavonol glycosides(PFGs)as its active ingredients.It has attracted much attention due to prominent healthcare and therapeutic effects,but faces problems of adulteration with closely related species and confusion about geographical origins.In this study,multiple technical approaches were employed to identify its genetic characteristics and metabolic differences.Based on DNA barcoding,20 batches of samples were analyzed.The genetic distances of matK,ITS and psbA-trnH within species were all smaller than those between species,and psbA-trnH along with ITS+psbA-trnH proved most effective in distinguishing botanical sources.With Inter-simple sequence repeat(ISSR)technology,12 highly polymorphic and reproducible primers were selected from 21,and 189 alleles were detected.Epimedium sagittatum showed distinct genetic diversity.Samples with similar genetic distance and geographical location also tended to cluster together.Eight index components were analyzed,and their contents showed significant differences.The total content ranged from 0.50%to 7.09%,and icariin and epimedin C were identified as potential biomarkers.Integrative analysis revealed that the differences in index components were jointly driven by genetic diversity and ecological factors.Additionally,“mean temperature of driest quarter”,“precipitation seasonality”,and“temperature annual range”were identified as key environmental factors.This study provides a reliable experimental basis for the authenticity and quality evaluation of Epimedium.展开更多
Understanding the spatial distributions and corresponding variation mechanisms of key soil nutrients in fragile karst ecosystems can assist in promoting sustainable development.However,due to the implementation of eco...Understanding the spatial distributions and corresponding variation mechanisms of key soil nutrients in fragile karst ecosystems can assist in promoting sustainable development.However,due to the implementation of ecological restoration initiatives such as land-use conversions,novel changes in the spatial characteristics of soil nutrients remain unknown.To address this gap,we explored nutrient variations and the drivers of the variation in the 0–15 cm topsoil layer using a regional-scale sampling method in a typical karst area in northwest Guangxi Zhuang Autonomous Region,Southwest China.Descriptive statistics,geostatistics,and spatial analysis were used to assess the soil nutrient variability.The results indicated that soil organic carbon(SOC),total nitrogen(TN),total phosphorus(TP),and total potassium(TK)concentrations showed moderate variations,with coefficients of variance being 0.60,0.60,0.71,and 0.72,respectively.Moreover,they demonstrated positive spatial autocorrelations,with global Moran's indices being 0.68,0.77,0.64,and 0.68,respectively.However,local Moran's index values were low,indicating large spatial variations in soil nutrients.The best-fitting semi-variogram models for SOC,TN,TP,and TK concentrations were spherical,Gaussian,exponential,and exponential,respectively.According to the classification criteria of the Second National Soil Census in China,SOC and TN concentrations were relatively sufficient,with the proportions of rich and very rich levels being up to 90.9 and 96.0%,respectively.TP concentration was in the mediumdeficient level,with the areas of medium and deficient levels accounting for 33.7 and 30.1%of the total,respectively.TK concentration was deficient,with the cumulative area of extremely deficient,very deficient,and deficient levels accounting for 87.6%of the total area.Consequently,the terrestrial ecosystems in the study area were more vulnerable to soil P and K than soil N deficiencies.Furthermore,variance partitioning analysis of the influencing factors showed that,except for the interactions,the single effect of other soil properties accounted more for soil nutrient variations than spatial and environmental variables.These results will aid in the future management of terrestrial ecosystems.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
To achieve low-carbon regulation of electric vehicle(EV)charging loads under the“dual carbon”goals,this paper proposes a coordinated scheduling strategy that integrates dynamic carbon factor prediction and multiobje...To achieve low-carbon regulation of electric vehicle(EV)charging loads under the“dual carbon”goals,this paper proposes a coordinated scheduling strategy that integrates dynamic carbon factor prediction and multiobjective optimization.First,a dual-convolution enhanced improved Crossformer prediction model is constructed,which employs parallel 1×1 global and 3×3 local convolutionmodules(Integrated Convolution Block,ICB)formultiscale feature extraction,combinedwith anAdaptive Spectral Block(ASB)to enhance time-series fluctuationmodeling.Based on high-precision predictions,a carbon-electricity cost joint optimization model is further designed to balance economic,environmental,and grid-friendly objectives.The model’s superiority was validated through a case study using real-world data from a renewable-heavy grid.Simulation results show that the proposed multi-objective strategy demonstrated a superior balance compared to baseline and benchmark models,achieving a 15.8%reduction in carbon emissions and a 5.2%reduction in economic costs,while still providing a substantial 22.2%reduction in the peak-valley difference.Its balanced performance significantly outperformed both a single-objective strategy and a state-of-the-art Model Predictive Control(MPC)benchmark,highlighting the advantage of a global optimization approach.This study provides theoretical and technical pathways for dynamic carbon factor-driven EV charging optimization.展开更多
文摘Understanding crash contributing factors is essential in safety management and improvement. These factors drive investment decisions, policies, regulations, and other safety-related initiatives. This paper analyzes factors that contribute to crash occurrence based on two national datasets in the United States (CISS and NASS-CDS) for the years 2017-2022 and 2010-2015, respectively. Three taxonomies were applied to enhance understanding of the various crash contributing factors. These taxonomies were developed based on previous research and practice and involved different groupings of human factors, vehicle factors, and roadway and environmental factors. Statistics for grouping the different types of factors and statistics for specific factors are provided. The results indicate that human factors are present in over 95% of crashes, roadway and environmental factors are present in over 45% of crashes, and vehicle factors are present in less than 2% of crashes. Regarding factors related to human error and vehicle maintenance, speeding is involved in over 25% of crashes, distraction is involved in over 20% of crashes, alcohol and drugs are involved in over 9% of crashes, and vehicle maintenance is involved in approximately 0.45% of crashes. Approximately 4.4% of crashes involve a driver who “looked but did not see.” Weather is involved in over 13% of crashes. Conclusions: The findings indicate that, consistent with previous research, human factors or human error are present in around 95% of crashes. Infrastructure and environmental factors contribute to about 45% of crashes. Vehicle factors contribute to only 1.67% - 1.71% of crashes. The results from this study could potentially be used to inform future safety management and improvement activities, including policy-making, regulation development, safe systems and systemic safety approaches to safety management, and other engineering, education, emergency response, enforcement, evaluation, and encouragement activities. The findings could also be used in the development of future Driver Assistance Technologies (DAT) systems and in enhancing existing technologies.
基金Supported by National Key Research and Development Program of China,No.2019YFE0190800.
文摘BACKGROUND Studies investigating diagnostic delays and their effects on patients with alcoholic cirrhosis.AIM To investigate the current status and associated factors influencing diagnostic delays in 401 patients with alcoholic cirrhosis.METHODS A cross-sectional analysis was conducted at a tertiary hospital in China from June 2020 to December 2023.Data were collected through telephone follow-ups and questionnaires.The Wilcoxon and Kruskal-Wallis H tests were used to compare diagnostic delays across various characteristics.Multivariate linear regression was employed to identify factors associated with diagnostic delays.RESULTS The median diagnostic delay was 5 months,with an interquartile range of 2-11 months.The proportions of patients with alcoholic cirrhosis who initially visited tertiary,secondary,and primary hospitals were 38.9%,37.91%,and 23.19%,respectively.Furthermore,the rates of patients undergoing liver computed tomography(CT)during their first visit at tertiary,secondary,and primary hospitals were 92.95%,13.82%,and 1.08%,respectively(P<0.001).Significant differences were observed in diagnostic delay-related characteristics,including residence,resident type,initial diagnosis,medical insurance,liver CT,and liver ultrasound during the first visit,age,years of education,family size,marital status,annual family income,years of drinking,daily alcohol consumption,and type of alcohol consumed(P<0.01).Furthermore,diagnostic delays were variably associated with daily alcohol consumption and other characteristics(i.e.residence,years of drinking,medical insurance,years of education,annual family income,liver CT and ultrasound during the first visit).Significant predictors of diagnostic delay identified on multivariate linear regression analysis included years of education,daily alcohol consumption,annual family income and blood ammonia levels(P<0.01).Patients with alcoholic cirrhosis experience varying degrees of diagnostic delays,necessitating interventions targeting potential contributing factors.CONCLUSION Our study indicates that patients with alcoholic cirrhosis may experience varying degrees of diagnostic delay.Interventions targeting potential factors contributing to diagnostic delay are necessary.
基金supported by the National Natural Science Foundation of China,Nos.82072165 and 82272256(both to XM)the Key Project of Xiangyang Central Hospital,No.2023YZ03(to RM)。
文摘Spinal cord injury represents a severe form of central nervous system trauma for which effective treatments remain limited.Microglia is the resident immune cells of the central nervous system,play a critical role in spinal cord injury.Previous studies have shown that microglia can promote neuronal survival by phagocytosing dead cells and debris and by releasing neuroprotective and anti-inflammatory factors.However,excessive activation of microglia can lead to persistent inflammation and contribute to the formation of glial scars,which hinder axonal regeneration.Despite this,the precise role and mechanisms of microglia during the acute phase of spinal cord injury remain controversial and poorly understood.To elucidate the role of microglia in spinal cord injury,we employed the colony-stimulating factor 1 receptor inhibitor PLX5622 to deplete microglia.We observed that sustained depletion of microglia resulted in an expansion of the lesion area,downregulation of brain-derived neurotrophic factor,and impaired functional recovery after spinal cord injury.Next,we generated a transgenic mouse line with conditional overexpression of brain-derived neurotrophic factor specifically in microglia.We found that brain-derived neurotrophic factor overexpression in microglia increased angiogenesis and blood flow following spinal cord injury and facilitated the recovery of hindlimb motor function.Additionally,brain-derived neurotrophic factor overexpression in microglia reduced inflammation and neuronal apoptosis during the acute phase of spinal cord injury.Furthermore,through using specific transgenic mouse lines,TMEM119,and the colony-stimulating factor 1 receptor inhibitor PLX73086,we demonstrated that the neuroprotective effects were predominantly due to brain-derived neurotrophic factor overexpression in microglia rather than macrophages.In conclusion,our findings suggest the critical role of microglia in the formation of protective glial scars.Depleting microglia is detrimental to recovery of spinal cord injury,whereas targeting brain-derived neurotrophic factor overexpression in microglia represents a promising and novel therapeutic strategy to enhance motor function recovery in patients with spinal cord injury.
基金supported by the Global Alliance for TB Drug Development(TB Alliance)the Global Fund(No.:HK.05.01/1/34.3/2018)the World Health Organization(WHO).
文摘Objective:To analyze the risk factors associated with multidrug-resistant tuberculosis(MDR-TB)as a first national survey in Indonesia.Methods:This national coverage cross-sectional study was conducted from 2017 to 2018.The study subjects were selected using a multi-stage probability random sampling method.MDR-TB is tuberculosis caused by bacteria resistant to at least isoniazid and rifampicin.The dependent variable was MDR-TB.Independent variables included age,sex,education,employment status,place of residence,history of living with TB patients,and the number of household members.Univariate and multivariate logistic regression models were used to analyze the risk factors associated with MDR-TB.All the data were analyzed using STATA V.14.0(Stata Corp LLC,College Station,TX).Results:This study found the MDR rate was 109/3234(3.4%)among positive pulmonary TB patients.More than twice as many patients had MDR re-treatment(74/3234,2.3%),compared to 35/3234(1.1%)who had new TB diagnoses or were getting initial treatment.After adjusting for employment status,individuals with a prior history of tuberculosis treatment were found to have significantly higher odds of developing MDR-TB,with an odds ratio of 7.22(95%CI 3.87-13.44).Conclusions:Increasing attention should be paid to these patients to prevent MDR-TB,and MDR-TB transmission is an urgent challenge for controlling TB worldwide.Early detection of MDR-TB is a critical part of TB control programs.
基金Supported by the National Natural Science Foundation of China,No.82305035China Academy of Chinese Medical Sciences,Special Project for Cultivating Outstanding Young Scientific and Technological Talents,No.2217-YQ-029Institute of Acupuncture,China Academy of Chinese Medical Sciences,Special Project for Innovative Talents,No.ZZ-YC2023002.
文摘Autism spectrum disorder is a mental neurodevelopmental condition characterized by social deficits and repetitive behavior,and its development is influenced by genetic and environmental factors.Furthermore,an important factor in etiology is the health status of the mother during pregnancy.Maternal health can critically affect the development of the offspring’s nervous system,including the central nervous system and enteric nervous system.Unfavorable maternal health can disrupt the normal development of the offspring’s nervous system in various ways,such as changes in microbiota composition.As one of the common comorbidities of autism spectrum disorder,no consistent conclusion has been drawn on how poor maternal health affects enteric nervous system and cen-tral nervous system development in offspring.From the perspective of maternal health,this review discusses how maternal status affects the gastrointestinal health of offspring and the development of mental systems to raise public awar-eness of maternal health and provide a new idea for eugenics and childbearing.
基金supported by the 2025 Fujian Provincial Social Science Foundation Project(FJ2025C074).
文摘This systematic review synthesizes empirical research on external risk factors for adolescent smartphone addiction.Scopus and Web of Science were searched for English peer-reviewed empirical articles from 2008 onward;28 met inclusion criteria(excluding non-adolescents,generic internet addiction,non-empirical work,or non-English).Thematic synthesis organized findings into three external risk domains—family,school,and peers—considering cultural/contextual mechanisms.Family dynamics(parental phubbing,harsh parenting,dysfunction),school stressors,and adverse peer relationships were identified as accumulating,direct and indirect contributors to smartphone addiction.These operate within a techno-ecological framework,where digital technologies amplify vulnerabilities and create new pathways for maladaptive use.Evidence favors an ecological,multi-level perspective.Future research should use longitudinal designs,standardize measures across cultures,and examine understudied regions—especially Africa—to guide culturally sensitive interventions.
文摘BACKGROUND Ischemic stroke is one of the leading global causes of disability and death.Despite advances in modern medical technology that improve acute treatment and rehabilitation measures,post-stroke anxiety and depression(PSD)do not receive sufficient attention.AIM To systematically evaluate risk factors and early identification markers for PSD for more precise screening and intervention strategies in clinical practice.METHODS This retrospective study analyzed clinical data from 112 patients with ischemic stroke admitted between January 2022 and December 2024.Based on assessments using the Hamilton Rating Scale for Anxiety(HAMA)and Hamilton Rating Scale for Depression(HAMD)at 2 weeks(±3 days)post-stroke,patients were classified into the PSD group(HAMA≥7 and/or HAMD≥7)and the non-PSD group(HAMA<7 and HAMD<7).Observation indicators included psychological assessment,demographic and clinical characteristics,stroke-related clinical indicators,neuroimaging assessments,and laboratory biomarkers.Multivariate logistic regression analysis was used to identify independent risk factors for PSD,and receiver operating characteristic curve analysis was used to evaluate the diagnostic value of potential biomarkers.RESULTS Of the 112 patients,46(41.1%)were diagnosed with PSD.Multivariate analysis identified five independent risk factors:Female gender[Odds ratio(OR)=2.32,95%confidence interval(CI):1.56-3.45],history of mental disorders prior to stroke(OR=3.17,95%CI:1.89-5.32),infarct location in the frontal lobe or limbic system(OR=2.86,95%CI:1.73-4.71),stroke severity with National Institutes of Health Stroke Scale≥8 at admission(OR=2.54,95%CI:1.62-3.99),and low social support(Social Support Rating Scale<35,OR=2.18,95%CI:1.42-3.36).Subgroup analysis showed that depression patients more commonly had left hemisphere lesions(68.4%vs 45.2%),while anxiety patients more frequently presented with right hemisphere lesions(59.5%vs 39.5%).The PSD group exhibited larger infarct volumes(8.7 cm^(3) vs 5.3 cm^(3)),more severe white matter hyperintensities,and more pronounced frontal lobe atrophy.Analysis of inflammatory markers showed significantly elevated levels of interleukin-6(7.8 pg/mL vs 4.5 pg/mL)and tumor necrosis factor-alpha(15.6 pg/mL vs 9.8 pg/mL)in the PSD group,while hypothalamicpituitary-adrenal axis function assessment revealed higher cortisol levels(386.5±92.3 nmol/L vs 328.7±75.6 nmol/L)and flattened diurnal rhythm in the PSD group.CONCLUSION PSD is a complex neuropsychiatric consequence of stroke involving disruption of the frontal-limbic circuitry,neuroinflammatory responses,and dysfunction of the hypothalamic-pituitary-adrenal axis.
基金supported by grants from the Zhejiang Provincial TCM Science and Technology Plan Project,No.2023ZL156(to YH)Ningbo Top Medical and Health Research Program,No.2022020304(to XG)+1 种基金the Natural Science Foundation of Ningbo,No.2023J019(to YH)Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province,No.2022E10026(to YH)。
文摘Strokes include both ischemic stroke,which is mediated by a blockade or reduction in the blood supply to the brain,and hemorrhagic stroke,which comprises intracerebral hemorrhage and subarachnoid hemorrhage and is characterized by bleeding within the brain.Stroke is a lifethreatening cerebrovascular condition characterized by intricate pathophysiological mechanisms,including oxidative stress,inflammation,mitochondrial dysfunction,and neuronal injury.Critical transcription factors,such as nuclear factor erythroid 2-related factor 2 and nuclear factor kappa B,play central roles in the progression of stroke.Nuclear factor erythroid 2-related factor 2 is sensitive to changes in the cellular redox status and is crucial in protecting cells against oxidative damage,inflammatory responses,and cytotoxic agents.It plays a significant role in post-stroke neuroprotection and repair by influencing mitochondrial function,endoplasmic reticulum stress,and lysosomal activity and regulating metabolic pathways and cytokine expression.Conversely,nuclear factor-kappa B is closely associated with mitochondrial dysfunction,the generation of reactive oxygen species,oxidative stress exacerbation,and inflammation.Nuclear factor-kappa B contributes to neuronal injury,apoptosis,and immune responses following stroke by modulating cell adhesion molecules and inflammatory mediators.The interplay between these pathways,potentially involving crosstalk among various organelles,significantly influences stroke pathophysiology.Advancements in single-cell sequencing and spatial transcriptomics have greatly improved our understanding of stroke pathogenesis and offer new opportunities for the development of targeted,individualized,cell typespecific treatments.In this review,we discuss the mechanisms underlying the involvement of nuclear factor erythroid 2-related factor 2 and nuclear factor-kappa B in both ischemic and hemorrhagic stroke,with an emphasis on their roles in oxidative stress,inflammation,and neuroprotection.
文摘BACKGROUND:Acute pain is a sudden experience secondary to injuries and varies in perception among individuals.In trauma patients,it can negatively aff ect respiratory function,immune response,and wound healing,making it a signifi cant public health concern.This study is to determine the prevalence and factors associated with acute pain among emergency trauma patients.METHODS:A multicenter cross-sectional study was conducted.Data were collected via interviewer-administered questionnaires and patient chart review.The data were analyzed via the statistical package for social science version 25.Bivariable and multivariable logistic regression analyses were used.Variables with a P-value<0.05 were considered statistically signifi cant.RESULTS:A total of 397 patients were included in the study,for a response rate of 96.8%.The prevalence of pain during admission was 91.9%(95%confi dence intervals[95%CIs]:88.8%-94.4%).Blunt trauma(adjusted odds ratio[aOR]=2.82;95%CI:1.23-6.45),analgesia before admission to the emergency department(aOR=2.71;95%CI:1.16-6.36),documentation of pain severity in the chart(aOR=2.71;95%CI:1.16-6.36),analgesia provided within two hours after admission(aOR=7.60;95%CI:2.79-20.68),use of non-pharmacological pain management methods(aOR=3.09;95%CI:1.35-7.08)and availability of analgesia(aOR=3.95;95%CI:1.36-11.43)were associated with acute pain experience.CONCLUSION:The prevalence of acute pain among emergency trauma patients was high in the study area.Analgesia should be administered prior to admission,and non-pharmacological pain management should be implemented.Moreover,training on pain assessment and management should be provided for healthcare providers in the emergency department.
文摘Nerve trauma commonly results in chronic neuropathic pain. This is by triggering the release of proinflammatory mediators from local and invading cells that induce inflammation and nociceptive neuron hyperexcitability. Even without apparent inflammation, injury sites are associated with increased inflammatory markers. This review focuses on how it might be possible to reduce neuropathic pain by reducing inflammation. Physiologically, pain is resolved by a combination of the out-migration of pro-inflammatory cells from the injury site, the down-regulation of the genes underlying the inflammation, up-regulating genes for anti-inflammatory mediators, and reducing nociceptive neuron hyperexcitability. While various techniques reduce chronic neuropathic pain, the best are effective on < 50% of patients, no technique reliably or permanently eliminates neuropathic pain. This is because most techniques are predominantly aimed at reducing pain, not inflammation. In addition, while single factors reduce pain, increasing evidence indicates significant and longer-lasting pain relief requires multiple factors acting simultaneously. Therefore, it is not surprising that extensive data indicate that the application of platelet-rich plasma provides more significant and longer-lasting pain suppression than other techniques, although its analgesia is neither complete nor permanent. However, several case reports indicate that platelet-rich plasma can induce permanent neuropathic pain elimination when the platelet concentration is significantly increased and is applied to longer nerve lengths. This review examines the primary triggers of the development and maintenance of neuropathic pain and techniques that reduce chronic neuropathic pain. The application of plateletrich plasma holds great promise for providing complete and permanent chronic neuropathic pain elimination.
文摘BACKGROUND Post-transplant tertiary hyperparathyroidism(PT-tHPT)is a well-recognized complication following kidney transplantation,characterized by persistent excessive secretion of parathyroid hormone(PTH)despite improved renal function.It is potentially associated with an increased risk of cardiovascular events,renal osteodystrophy,pathologic fractures,graft loss,and mortality.AIM To evaluate the incidence,risk factors,and outcomes of PT-tHPT amongst kidney transplant recipients.METHODS A total of 887 transplant recipients who underwent transplantation between 2000 and 2020 were evaluated.Univariable and multivariable logistic regression was performed to determine the predictors of tertiary hyperparathyroidism.Graft and recipient outcomes were assessed using multivariable Cox regression.A separate multivariable Cox regression was performed to determine the effect of treatment strategies on outcomes.RESULTS PT-tHPT,defined as elevated PTH(>65 ng/L)and persistent hypercalcemia(>2.60 mmol/L),was diagnosed in 14%of recipients.Risk factors for PT-tHPT included older age[odds ratio(OR)=1.36,P<0.001],Asian ethnicity(OR=0.33,P=0.006),total ischemia time(OR=1.03,P=0.048 per hour),pre-transplant serum calcium(OR=1.38,P<0.001)per decile increase,pre-transplant PTH level(OR=1.31,P<0.001)per decile increase,longer dialysis duration(OR=1.12,P=0.002)per year,history of acute rejection(OR=2.37,P=0.012),and slope of estimated glomerular filtration rate change(OR=0.91,P=0.001).There were a 3.4-fold higher risk of death-censored graft loss and a 1.9-fold greater risk of recipient death with PT-tHPT.The three treatment strategies of conservative management,calcimimetic and parathyroidectomy did not significantly change the graft or patient outcome.CONCLUSION Pretransplant elevated calcium and PTH levels,older age and dialysis duration are associated with PT-tHPT.While PT-tHPT significantly affects graft and recipient survival,the treatment strategies did not affect survival.
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The National Key Research and Development Program of China,No.2023YFC3206601。
文摘Landslides pose a formidable natural hazard across the Qinghai-Tibet Plateau(QTP),endangering both ecosystems and human life.Identifying the driving factors behind landslides and accurately assessing susceptibility are key to mitigating disaster risk.This study integrated multi-source historical landslide data with 15 predictive factors and used several machine learning models—Random Forest(RF),Gradient Boosting Regression Trees(GBRT),Extreme Gradient Boosting(XGBoost),and Categorical Boosting(CatBoost)—to generate susceptibility maps.The Shapley additive explanation(SHAP)method was applied to quantify factor importance and explore their nonlinear effects.The results showed that:(1)CatBoost was the best-performing model(CA=0.938,AUC=0.980)in assessing landslide susceptibility,with altitude emerging as the most significant factor,followed by distance to roads and earthquake sites,precipitation,and slope;(2)the SHAP method revealed critical nonlinear thresholds,demonstrating that historical landslides were concentrated at mid-altitudes(1400-4000 m)and decreased markedly above 4000 m,with a parallel reduction in probability beyond 700 m from roads;and(3)landslide-prone areas,comprising 13%of the QTP,were concentrated in the southeastern and northeastern parts of the plateau.By integrating machine learning and SHAP analysis,this study revealed landslide hazard-prone areas and their driving factors,providing insights to support disaster management strategies and sustainable regional planning.
基金supported by ScientificResearch Fund of National Health Commission of the People’s Republic of China-Major Science and Technology Program for Medicine and Health in Zhejiang Province(WKJ-ZJ-2406).
文摘Objectives This study aimed to explore the lagged and cumulative effects of risk factors on disability in older adults using distributed lag non-linear models(DLNMs).Methods We utilized data from the China Health and Retirement Longitudinal Study(CHARLS).After feature selection via Elastic Net Regularization,we applied DLNMs to evaluate the lagged effects of risk factors.Disability was defined as the presence of any difficulties in basic activities of daily living(BADL).The cumulative relative risk(CRR)was calculated by summing the lag-specific risk estimates,representing the cumulative disability risk over the specified lag period.Effect modifications and sensitivity analyses were also performed.Results This study included a total of 2,318 participants.Early-phase lag factors,such as the difficulty in stooping(CRR=3.58;95%CI:2.31-5.55;P<0.001)and walking(CRR=2.77;95%CI:1.39-5.55;P<0.001),exerted the strongest effects immediately upon occurrence.Mid-phase lag factors,such as arthritis(CRR=1.51;95%CI:1.10-2.06;P=0.001),showed a resurgence in disability risk within 2-3 years.Late-phase lag factors,including depressive symptoms(CRR=2.38;95%CI:1.30-4.35;P<0.001)and elevated systolic blood pressure(CRR=1.64;95%CI:1.06-2.79;P=0.02),exhibited significant long-term cumulative risks.Conversely,grip strength(CRR=0.80;95%CI:0.54-0.95;P=0.02)and social participation(CRR=0.89;95%CI:0.73-0.99;P=0.04)were significant protective factors.Conclusions The findings underscore the importance of tailored interventions that account for various lag characteristics of different factors to effectively mitigate disability risk.Future studies should explore the underlying biological and sociological mechanisms of these lagged effects,identify intervention strategies that target risk factors with different lagged patterns,and evaluate their effectiveness.
基金Yunnan Provincial High-Level Traditional Chinese Medicine Talent Training ProjectYunnan Provincial Department of Science and Technology Traditional Chinese Medicine Basic Research Joint Special Project(Project No.:202101AZ070001-138)。
文摘Objective:Based on the theory of“Taiyang governs tendons”,to explore the effect of acupuncture at points of the Bladder Meridian of Foot-Taiyang on the expression of serum inflammatory factors in rabbit models of cervical spondylosis.Methods:Thirty New Zealand white rabbits were randomly divided into a blank group,a model group,and a treatment group,with 10 rabbits in each group.The models of cervical spondylosis in the model group and treatment group were established by long-term head-down flexion combined with cold-damp stimulation.After modeling,the treatment group received acupuncture at three points(Kunlun,Weizhong,and Feishu)on the Bladder Meridian of Foot-Taiyang,once a day for 20 minutes each time,for 14 consecutive days;the model group and blank group received no therapeutic intervention.After the intervention,cardiac blood was collected from all rabbits to detect the expression levels of serum inflammatory factors IL-6,TNF-α,and IL-1β.Meanwhile,cervical muscle tissue was collected,stained with HE,and the morphological changes of the posterior cervical muscle tissue in each group were observed under an optical microscope.Results:After modeling,the levels of inflammatory factors in the serum of rabbits in the model group and treatment group were significantly increased compared with those before modeling,with a statistically significant difference(p<0.01).After intervention,the serum inflammatory factors in the treatment group decreased significantly compared with those in the model group,and the difference was statistically significant(p<0.01).Conclusion:Acupuncture at points of the Bladder Meridian of Foot-Taiyang in rabbit models of cervical spondylosis can reduce the serum levels of inflammatory factors TNF-α,IL-1β,and IL-6.
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 Beijing Nova Program(20240484546)the Fundamental Research Funds for the Central Public Welfare Research Institutes(No.ZZ13-YQ-049,ZXKT22001)Shaanxi Province Key R&D Program Projects(2024SF-ZDCYL-03-10).
文摘Epimedium is commonly used to treat bone injury and kidney disease,with prenylated flavonol glycosides(PFGs)as its active ingredients.It has attracted much attention due to prominent healthcare and therapeutic effects,but faces problems of adulteration with closely related species and confusion about geographical origins.In this study,multiple technical approaches were employed to identify its genetic characteristics and metabolic differences.Based on DNA barcoding,20 batches of samples were analyzed.The genetic distances of matK,ITS and psbA-trnH within species were all smaller than those between species,and psbA-trnH along with ITS+psbA-trnH proved most effective in distinguishing botanical sources.With Inter-simple sequence repeat(ISSR)technology,12 highly polymorphic and reproducible primers were selected from 21,and 189 alleles were detected.Epimedium sagittatum showed distinct genetic diversity.Samples with similar genetic distance and geographical location also tended to cluster together.Eight index components were analyzed,and their contents showed significant differences.The total content ranged from 0.50%to 7.09%,and icariin and epimedin C were identified as potential biomarkers.Integrative analysis revealed that the differences in index components were jointly driven by genetic diversity and ecological factors.Additionally,“mean temperature of driest quarter”,“precipitation seasonality”,and“temperature annual range”were identified as key environmental factors.This study provides a reliable experimental basis for the authenticity and quality evaluation of Epimedium.
基金supported by the National Natural Science Foundation of China(U2344201 and 42101316)the Natural Science Foundation of Hunan Province,China(2022JJ40866)the Outstanding Youth Project of Education Bureau of Hunan Province,China(20B613)。
文摘Understanding the spatial distributions and corresponding variation mechanisms of key soil nutrients in fragile karst ecosystems can assist in promoting sustainable development.However,due to the implementation of ecological restoration initiatives such as land-use conversions,novel changes in the spatial characteristics of soil nutrients remain unknown.To address this gap,we explored nutrient variations and the drivers of the variation in the 0–15 cm topsoil layer using a regional-scale sampling method in a typical karst area in northwest Guangxi Zhuang Autonomous Region,Southwest China.Descriptive statistics,geostatistics,and spatial analysis were used to assess the soil nutrient variability.The results indicated that soil organic carbon(SOC),total nitrogen(TN),total phosphorus(TP),and total potassium(TK)concentrations showed moderate variations,with coefficients of variance being 0.60,0.60,0.71,and 0.72,respectively.Moreover,they demonstrated positive spatial autocorrelations,with global Moran's indices being 0.68,0.77,0.64,and 0.68,respectively.However,local Moran's index values were low,indicating large spatial variations in soil nutrients.The best-fitting semi-variogram models for SOC,TN,TP,and TK concentrations were spherical,Gaussian,exponential,and exponential,respectively.According to the classification criteria of the Second National Soil Census in China,SOC and TN concentrations were relatively sufficient,with the proportions of rich and very rich levels being up to 90.9 and 96.0%,respectively.TP concentration was in the mediumdeficient level,with the areas of medium and deficient levels accounting for 33.7 and 30.1%of the total,respectively.TK concentration was deficient,with the cumulative area of extremely deficient,very deficient,and deficient levels accounting for 87.6%of the total area.Consequently,the terrestrial ecosystems in the study area were more vulnerable to soil P and K than soil N deficiencies.Furthermore,variance partitioning analysis of the influencing factors showed that,except for the interactions,the single effect of other soil properties accounted more for soil nutrient variations than spatial and environmental variables.These results will aid in the future management of terrestrial ecosystems.
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.
基金Supported by State Grid Corporation of China Science and Technology Project:Research on Key Technologies for Intelligent Carbon Metrology in Vehicle-to-Grid Interaction(Project Number:B3018524000Q).
文摘To achieve low-carbon regulation of electric vehicle(EV)charging loads under the“dual carbon”goals,this paper proposes a coordinated scheduling strategy that integrates dynamic carbon factor prediction and multiobjective optimization.First,a dual-convolution enhanced improved Crossformer prediction model is constructed,which employs parallel 1×1 global and 3×3 local convolutionmodules(Integrated Convolution Block,ICB)formultiscale feature extraction,combinedwith anAdaptive Spectral Block(ASB)to enhance time-series fluctuationmodeling.Based on high-precision predictions,a carbon-electricity cost joint optimization model is further designed to balance economic,environmental,and grid-friendly objectives.The model’s superiority was validated through a case study using real-world data from a renewable-heavy grid.Simulation results show that the proposed multi-objective strategy demonstrated a superior balance compared to baseline and benchmark models,achieving a 15.8%reduction in carbon emissions and a 5.2%reduction in economic costs,while still providing a substantial 22.2%reduction in the peak-valley difference.Its balanced performance significantly outperformed both a single-objective strategy and a state-of-the-art Model Predictive Control(MPC)benchmark,highlighting the advantage of a global optimization approach.This study provides theoretical and technical pathways for dynamic carbon factor-driven EV charging optimization.
