Few studies have explored the acute effects of fine particulate matter(PM_(2.5))constituents on respiratory diseases(RDs),particularly across a broad spectrum of RD subtypes.We analyzed the associations between PM_(2....Few studies have explored the acute effects of fine particulate matter(PM_(2.5))constituents on respiratory diseases(RDs),particularly across a broad spectrum of RD subtypes.We analyzed the associations between PM_(2.5) and its five major constituents[organic matter(OM),black carbon(BC),sulfate(SO_(4)^(2−)),nitrate(NO_(3)^(−)),and ammonium(NH_(4)^(+))]and RDs(10 major categories and 35 specific)based on the hospitalization records from 153 hospitals in 20 provincial distractions from 2013 to 2020.We found that short-term exposure(lag 0−1)to PM_(2.5) constituents per interquartile range increase was associated with higher hospitalization risks for acute upper respiratory infections,influenza and pneumonia,other acute lower respiratory infections,chronic lower respiratory diseases,other diseases of the pleura,and other diseases of the respiratory system;the effect estimates were 2.45−2.99%,2.02−2.71%,2.98−3.62%,3.06−3.65%,3.22−4.52%,and 2.23−3.66%,respectively.Among 35 specific RDs,12 were significantly affected by PM_(2.5) and its constituents.Individuals aged>60 years were sensitive to PM_(2.5) constituent exposure.Our individual-level nationwide study provided a more comprehensive perspective on the associations between PM_(2.5) constituents and various major and specific RDs,highlighting the necessity of prioritizing targeted control strategies for key constituents to effectively mitigate the burden of RDs in China.展开更多
Stock volatility constitutes an adverse psychological stressor,but few large-scale studies have focused on its impact on major adverse cardiovascular events(MACEs)and suicide.Here,we conducted an individual-level time...Stock volatility constitutes an adverse psychological stressor,but few large-scale studies have focused on its impact on major adverse cardiovascular events(MACEs)and suicide.Here,we conducted an individual-level time-stratified case-crossover study to explore the association of daily stock volatility(daily returns and intra-daily oscillations for three kinds of stock indices)with MACEs and suicide among more than 12 million individual decedents from all counties in the mainland of China between 2013 and 2019.For daily stock returns,both stock increases and decreases were associated with increased mortal-ity risks of all MACEs and suicide.There were consistent and positive associations between intra-daily stock oscillations and mortality due to MACEs and suicide.The excess mortality risks occurred at the cur-rent day(lag 0 d),persisted for two days,and were greatest for suicide and hemorrhagic stroke.Taking the present-day Shanghai and Shenzhen 300 Index as an example,a 1%decrease in daily returns was associated with 0.74%-1.04%and 1.77%increases in mortality risks of MACEs and suicide,respectively;the corresponding risk increments were 0.57%-0.85%and 0.92%for a 1%increase in daily returns and 0.67%-0.77%and 1.09%for a 1%increase in intra-daily stock oscillations.The excess risks were more pro-nounced among individuals aged 65-74 years,males,and those with lower education levels.Our findings revealed considerable health risks linked to sociopsychological stressors,which are helpful for the gov-ernment and general public to mitigate the immediate cardiovascular and mental health risks associated with stock market volatility.展开更多
AIM:To evaluate the possibility of an association between polyethylene glycol(PEG) and acute renal failure(ARF) in elderly patients using a health insurance claims database.METHODS:We conducted a population-based case...AIM:To evaluate the possibility of an association between polyethylene glycol(PEG) and acute renal failure(ARF) in elderly patients using a health insurance claims database.METHODS:We conducted a population-based casecrossover study using information obtained from Korean Health Insurance Review and Assessment Service(HIRA) claims from January 1,2005 to December 31,2005(Seoul,Korea).The study population consisted of elderly patients who received PEG prior to experiencing their first ARF-related hospitalization from April 1,2005 to December 31,2005.For each patient,one case and two control periods were matched.PEG use in a 2-or 4-wk window period prior to hospitalization for ARF was compared with PEG use in two earlier 2-or 4-wk control window periods.Conditional logistic regression analysis was used to estimate odds ratios(ORs) and 95% CI,adjusting for concomitant uses of diuretics,angiotensin converting enzyme inhibitors,non-steroidal anti-inflammatory drugs,antibiotics,anti-cancer drugs,and contrast media.RESULTS:Within the HIRA database which contained 1 093 262 elderly patients,1156 hospitalized ARF cases were identified.Among these cases,PEG was prescribed to 17(1.5%) patients before hospitalization.The adjusted ORs when applying the 2-and 4-wk window periods were 0.4(95% CI:0.03-5.24) and 2.1(95% CI:0.16-27.78),respectively.CONCLUSION:No increased risk of ARF was found in elderly PEG users.However,based on the limited number of study subjects,further analysis should be performed to confirm these results.展开更多
Falls represent a significant public health issue worldwide.Previous studies have demonstrated associations of temperature with fall risk,but the effect and burden of hourly relative humidity and fall morbidity have b...Falls represent a significant public health issue worldwide.Previous studies have demonstrated associations of temperature with fall risk,but the effect and burden of hourly relative humidity and fall morbidity have been rarely investigated.Fall data and meteorological data were collected from the National Injury Surveillance System during 2006−2021 in China.Associations between hourly relative humidity and fall onset were analyzed using conditional logistic regression combined with a distributed lag nonlinear model.Stratified analysis was used to identify potential association modifiers.Several sensitivity analyses were applied to examine the robustness of the results.The study involved 4197495 fall-related cases.Relative humidity exhibited monotonic relationships with the fall onset risk.The excess risk(ER)of falls appeared immediately at lag 0 h and persisted for 8 h.A 10%decrease in relative humidity was associated with a 1.35%(95%confidence interval[CI]:0.83−1.87%)increase in excess risk of falls and much higher risk for males(ER=1.89%,95%CI:1.29−2.48%)than that for females(ER=0.52%,95%CI:0.14−0.90%).The excess risk of fall injury was the highest among individuals aged 5−14 years(ER=3.45%,95%CI:2.57−4.32%)compared to other age groups.Moreover,compared to the highest relative humidity,the attributable fraction(AF)due to low relative humidity exposure was 4.94%(95%CI:4.88−4.98%).Subgroup analyses revealed that males,individuals aged 5−14 years,students,cases occurring in public places,and cases engaged in sports activities were more susceptible to relative humidity than their correspondents.Regional disparities were observed,with individuals in southern China or warm regions showing greater sensitivity to changes in relative humidity.Results of this study suggest that hourly low relative humidity exposure is associated with an increased risk of fall onset.These findings underscore the necessity of time-specific interventions to mitigate the relative humidity risk.展开更多
Few multicity studies have examined the acute effects of nitrogen dioxide(NO_(2))on respiratory disease(RD),especially its specific causes.This study aimed to investigate the associations between short-term exposure t...Few multicity studies have examined the acute effects of nitrogen dioxide(NO_(2))on respiratory disease(RD),especially its specific causes.This study aimed to investigate the associations between short-term exposure to NO_(2)and hospitalization of full-spectrum RDs in China.Hospitalization of 10 major categories and 40 cause-specific RDs were obtained from 20 provinces over the study period of 2013−2020.A time-stratified case-crossover study was conducted at the individual level to explore the associations between NO_(2)and RDs.NO_(2)was significantly associated with increased hospitalization of eight major RDs(acute upper respiratory infections,influenza and pneumonia,acute lower respiratory infections,upper respiratory tract diseases,chronic lower respiratory diseases,respiratory interstitium diseases,pleura diseases,and other respiratory diseases)and 18 specific causes of RDs,with the largest associations observed on lag 0−1 day.The effect estimates ranged from 0.75 to 4.09%per 10μg/m^(3)of NO_(2)exposure.The associations remained robust after controlling for copollutants.The concentration−response curves were mostly positive and linear.This nationwide study provides comprehensive information on the acute effects of NO_(2)on respiratory morbidity across the full spectrum,highlighting the need for caution with regard to this important traffic-related air pollutant in current pollution control programs.展开更多
Few national studies have systemically examined the effects of criteria air pollutants on cardiovascular morbidity.This study aimed to investigate the associations between all criteria air pollutants and hospitalizati...Few national studies have systemically examined the effects of criteria air pollutants on cardiovascular morbidity.This study aimed to investigate the associations between all criteria air pollutants and hospitalization of causespecific cardiovascular diseases(CVD)in China.We obtained data on CVD hospitalization events of four major categories and 12 specific diseases from 153 hospitals distributed in 20 provincial-level regions from 2013 to 2020.We adopted a time-stratified case-crossover study design using individual cases to capture the effect of short-term exposure to six criteria air pollutants on CVD hospitalizations,using conditional logistic regression models.More than 1.1 million CVD hospitalization events were included.The lag pattern exploration demonstrated the largest effect for six air pollutants on lag 0–1 day.PM_(2.5),PM_(10),NO_(2),and CO were significantly associated with increased hospitalization from ischemic heart diseases,cerebrovascular diseases,other heart diseases,and five specific causes of CVD.The effect estimates of NO_(2)were the most robust when adjusting for copollutants.The concentration-response curves were positive and linear for most pollutant–endpoint pairs(except for O_(3)),and these positive associations remained even below the 24-h levels recommended by WHO Air Quality Guidelines and China Air Quality Standards.This nationwide case-crossover study in China demonstrated that short-term exposure to multiple ambient air pollutants may significantly increase the risk of cause-specific CVD hospitalizations even under the most stringent air quality regulations,striking an alert for potential CVD patients against these environmental risk factors.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
Incident chronic kidney disease(CKD)may be accelerated(could be indicated by repeated admissions to the hospital)by environmental triggers such as ambient particulate matter(PM).Additionally,hospital admission is a se...Incident chronic kidney disease(CKD)may be accelerated(could be indicated by repeated admissions to the hospital)by environmental triggers such as ambient particulate matter(PM).Additionally,hospital admission is a sensitive proxy reflecting the disease burden.However,the association of PM exposure with hospital admissions for CKD is still unknown,let alone the excess risks(ERs)in hospital admissions for CKD due to high PM level exposure.In this study,a two-stage time-stratified case-crossover study was conducted to investigate the association of ambient air PM exposure with hospital admission for CKD in 282 Chinese cities of prefecture-level or above during 2013–2017.City-specific associations of single and cumulative 0–3 days lagged exposure to fine particulate matter(PM_(2.5))and inhalable particles(PM_(10))with hospital admissions for total CKD and its subtypes were evaluated by the conditional logistic regression model,then were pooled using the random-effect model.A total of 3,490,416 hospital admissions for CKD were identified.We found that per interquartile range(IQR)increment in PM_(2.5) at lag02 and per IQR increment in PM_(10) at lag03 were associated with increases of 2.36%(95%CI:1.58%,3.14%)and 2.87%(95%CI:1.91%,3.85%)in hospital admissions for total CKD,respectively.Compared to control concentrations(PM_(2.5):35μg/m^(3);PM_(10):50μg/m^(3)),the largest ERs in hospital admissions for total CKD were 2.63%(95%CI:2.15%–3.11%)and 4.45%(95%CI:3.85%–5.06%)in association with exposure to heavily excessive PM_(2.5)(≥75μg/m^(3))and PM_(10)(≥150μg/m^(3)),respectively.Moreover,the attributable fractions(AFs)for CKD admissions were 2.83%for PM_(2.5) and 3.46%for PM_(10) during the study period.These findings suggested that exposure to PM_(2.5) and PM_(10) is associated with substantially increased risk and burden of CKD admissions.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： To compare the use of the suprapubic puncture method versus the transurethral method in pressure-flow studies in patients with benign prostatic hyperplasia. Methods： Twenty-three men with benign prostatic hyper...Aim： To compare the use of the suprapubic puncture method versus the transurethral method in pressure-flow studies in patients with benign prostatic hyperplasia. Methods： Twenty-three men with benign prostatic hyperplasia underwent both suprapubic and transurethral pressure-flow studies during a single session. Standard pressure-flow variables were recorded in all patients with both methods, enabling calculation of obstruction using commonly used grading systems, such as the urethral resistance algorithm, the Abrams-Griffith （AG） number and the Schaefer linear nomogram. Results： There were statistically significant differences between the methods in the mean values of maximum flow rate （P 〈 0.05）, detrusor pressure at the maximum flow （P 〈 0.01）, urethral resistance algorithm （P 〈 0.01）, AG number （P 〈 0.01） and maximum cystic capacity （P 〈 0.01）. Of the men in the study, 10 （43.5%） remained in the same Schaefer class with both methods and 18 （78.3%） in the same AG number area. Using the transurethral method, 12 （52.2%） men increased their Schaefer class by one and 1 （4.3%） by two. There were also differences between the suprapubic and transurethral methods using the AG number： 4 （17.4%） men moved from a classification of equivocal to obstructed and 1 （4.3%） from unobstructed to equivocal. Conclusion： The differences between the techniques for measuring intravesical pressure alter the grading of obstruction determined by several of the commonly used classifications. An 8 F transurethral catheter significantly increases the likelihood of a diagnosis of bladder outlet obstruction when compared with the suprapubic method.展开更多
基金supported by the National Natural Science Foundation of China(82422065)the National Key Research and Development Program of China(2022YFC2704604)+1 种基金the Shanghai 3-year Public Health Action Plan(GWVI-11.2-YQ32,GWVI-11.1-39,GWVI-11.2-YQ31)the Shanghai B&R Joint Laboratory Project(22230750300).
文摘Few studies have explored the acute effects of fine particulate matter(PM_(2.5))constituents on respiratory diseases(RDs),particularly across a broad spectrum of RD subtypes.We analyzed the associations between PM_(2.5) and its five major constituents[organic matter(OM),black carbon(BC),sulfate(SO_(4)^(2−)),nitrate(NO_(3)^(−)),and ammonium(NH_(4)^(+))]and RDs(10 major categories and 35 specific)based on the hospitalization records from 153 hospitals in 20 provincial distractions from 2013 to 2020.We found that short-term exposure(lag 0−1)to PM_(2.5) constituents per interquartile range increase was associated with higher hospitalization risks for acute upper respiratory infections,influenza and pneumonia,other acute lower respiratory infections,chronic lower respiratory diseases,other diseases of the pleura,and other diseases of the respiratory system;the effect estimates were 2.45−2.99%,2.02−2.71%,2.98−3.62%,3.06−3.65%,3.22−4.52%,and 2.23−3.66%,respectively.Among 35 specific RDs,12 were significantly affected by PM_(2.5) and its constituents.Individuals aged>60 years were sensitive to PM_(2.5) constituent exposure.Our individual-level nationwide study provided a more comprehensive perspective on the associations between PM_(2.5) constituents and various major and specific RDs,highlighting the necessity of prioritizing targeted control strategies for key constituents to effectively mitigate the burden of RDs in China.
基金supported by the National Key Research and Development Program(2022YFC3702701)the Shanghai Municipal Science and Technology Commission(21TQ015)the Shanghai International Science and Technology Partnership Project,China(21230780200).
文摘Stock volatility constitutes an adverse psychological stressor,but few large-scale studies have focused on its impact on major adverse cardiovascular events(MACEs)and suicide.Here,we conducted an individual-level time-stratified case-crossover study to explore the association of daily stock volatility(daily returns and intra-daily oscillations for three kinds of stock indices)with MACEs and suicide among more than 12 million individual decedents from all counties in the mainland of China between 2013 and 2019.For daily stock returns,both stock increases and decreases were associated with increased mortal-ity risks of all MACEs and suicide.There were consistent and positive associations between intra-daily stock oscillations and mortality due to MACEs and suicide.The excess mortality risks occurred at the cur-rent day(lag 0 d),persisted for two days,and were greatest for suicide and hemorrhagic stroke.Taking the present-day Shanghai and Shenzhen 300 Index as an example,a 1%decrease in daily returns was associated with 0.74%-1.04%and 1.77%increases in mortality risks of MACEs and suicide,respectively;the corresponding risk increments were 0.57%-0.85%and 0.92%for a 1%increase in daily returns and 0.67%-0.77%and 1.09%for a 1%increase in intra-daily stock oscillations.The excess risks were more pro-nounced among individuals aged 65-74 years,males,and those with lower education levels.Our findings revealed considerable health risks linked to sociopsychological stressors,which are helpful for the gov-ernment and general public to mitigate the immediate cardiovascular and mental health risks associated with stock market volatility.
文摘AIM:To evaluate the possibility of an association between polyethylene glycol(PEG) and acute renal failure(ARF) in elderly patients using a health insurance claims database.METHODS:We conducted a population-based casecrossover study using information obtained from Korean Health Insurance Review and Assessment Service(HIRA) claims from January 1,2005 to December 31,2005(Seoul,Korea).The study population consisted of elderly patients who received PEG prior to experiencing their first ARF-related hospitalization from April 1,2005 to December 31,2005.For each patient,one case and two control periods were matched.PEG use in a 2-or 4-wk window period prior to hospitalization for ARF was compared with PEG use in two earlier 2-or 4-wk control window periods.Conditional logistic regression analysis was used to estimate odds ratios(ORs) and 95% CI,adjusting for concomitant uses of diuretics,angiotensin converting enzyme inhibitors,non-steroidal anti-inflammatory drugs,antibiotics,anti-cancer drugs,and contrast media.RESULTS:Within the HIRA database which contained 1 093 262 elderly patients,1156 hospitalized ARF cases were identified.Among these cases,PEG was prescribed to 17(1.5%) patients before hospitalization.The adjusted ORs when applying the 2-and 4-wk window periods were 0.4(95% CI:0.03-5.24) and 2.1(95% CI:0.16-27.78),respectively.CONCLUSION:No increased risk of ARF was found in elderly PEG users.However,based on the limited number of study subjects,further analysis should be performed to confirm these results.
基金supported by the National Natural Science Foundation of China(42075173,W.M.,42275187,W.M.)Young Elite Scientists Sponsorship Program by CAST(2022QNRC001,G.H.).
文摘Falls represent a significant public health issue worldwide.Previous studies have demonstrated associations of temperature with fall risk,but the effect and burden of hourly relative humidity and fall morbidity have been rarely investigated.Fall data and meteorological data were collected from the National Injury Surveillance System during 2006−2021 in China.Associations between hourly relative humidity and fall onset were analyzed using conditional logistic regression combined with a distributed lag nonlinear model.Stratified analysis was used to identify potential association modifiers.Several sensitivity analyses were applied to examine the robustness of the results.The study involved 4197495 fall-related cases.Relative humidity exhibited monotonic relationships with the fall onset risk.The excess risk(ER)of falls appeared immediately at lag 0 h and persisted for 8 h.A 10%decrease in relative humidity was associated with a 1.35%(95%confidence interval[CI]:0.83−1.87%)increase in excess risk of falls and much higher risk for males(ER=1.89%,95%CI:1.29−2.48%)than that for females(ER=0.52%,95%CI:0.14−0.90%).The excess risk of fall injury was the highest among individuals aged 5−14 years(ER=3.45%,95%CI:2.57−4.32%)compared to other age groups.Moreover,compared to the highest relative humidity,the attributable fraction(AF)due to low relative humidity exposure was 4.94%(95%CI:4.88−4.98%).Subgroup analyses revealed that males,individuals aged 5−14 years,students,cases occurring in public places,and cases engaged in sports activities were more susceptible to relative humidity than their correspondents.Regional disparities were observed,with individuals in southern China or warm regions showing greater sensitivity to changes in relative humidity.Results of this study suggest that hourly low relative humidity exposure is associated with an increased risk of fall onset.These findings underscore the necessity of time-specific interventions to mitigate the relative humidity risk.
基金supported by the National Natural Science Foundation of China(Grant Nos.92043301,82103790)the Shanghai International Science and Technology Partnership Project(Grant No.21230780200).
文摘Few multicity studies have examined the acute effects of nitrogen dioxide(NO_(2))on respiratory disease(RD),especially its specific causes.This study aimed to investigate the associations between short-term exposure to NO_(2)and hospitalization of full-spectrum RDs in China.Hospitalization of 10 major categories and 40 cause-specific RDs were obtained from 20 provinces over the study period of 2013−2020.A time-stratified case-crossover study was conducted at the individual level to explore the associations between NO_(2)and RDs.NO_(2)was significantly associated with increased hospitalization of eight major RDs(acute upper respiratory infections,influenza and pneumonia,acute lower respiratory infections,upper respiratory tract diseases,chronic lower respiratory diseases,respiratory interstitium diseases,pleura diseases,and other respiratory diseases)and 18 specific causes of RDs,with the largest associations observed on lag 0−1 day.The effect estimates ranged from 0.75 to 4.09%per 10μg/m^(3)of NO_(2)exposure.The associations remained robust after controlling for copollutants.The concentration−response curves were mostly positive and linear.This nationwide study provides comprehensive information on the acute effects of NO_(2)on respiratory morbidity across the full spectrum,highlighting the need for caution with regard to this important traffic-related air pollutant in current pollution control programs.
基金supported by the National Natural Science Foundation of China(grant numbers 92043301 and 91843302)the Shanghai International Science and Technology Partnership Project(grant number 21230780200).
文摘Few national studies have systemically examined the effects of criteria air pollutants on cardiovascular morbidity.This study aimed to investigate the associations between all criteria air pollutants and hospitalization of causespecific cardiovascular diseases(CVD)in China.We obtained data on CVD hospitalization events of four major categories and 12 specific diseases from 153 hospitals distributed in 20 provincial-level regions from 2013 to 2020.We adopted a time-stratified case-crossover study design using individual cases to capture the effect of short-term exposure to six criteria air pollutants on CVD hospitalizations,using conditional logistic regression models.More than 1.1 million CVD hospitalization events were included.The lag pattern exploration demonstrated the largest effect for six air pollutants on lag 0–1 day.PM_(2.5),PM_(10),NO_(2),and CO were significantly associated with increased hospitalization from ischemic heart diseases,cerebrovascular diseases,other heart diseases,and five specific causes of CVD.The effect estimates of NO_(2)were the most robust when adjusting for copollutants.The concentration-response curves were positive and linear for most pollutant–endpoint pairs(except for O_(3)),and these positive associations remained even below the 24-h levels recommended by WHO Air Quality Guidelines and China Air Quality Standards.This nationwide case-crossover study in China demonstrated that short-term exposure to multiple ambient air pollutants may significantly increase the risk of cause-specific CVD hospitalizations even under the most stringent air quality regulations,striking an alert for potential CVD patients against these environmental risk factors.
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National Key Research and Development Program of China(grant number:2022YFC3702604 and 2022YFC3702704)Youth Top Talent Program of Xi’an Jiaotong University.
文摘Incident chronic kidney disease(CKD)may be accelerated(could be indicated by repeated admissions to the hospital)by environmental triggers such as ambient particulate matter(PM).Additionally,hospital admission is a sensitive proxy reflecting the disease burden.However,the association of PM exposure with hospital admissions for CKD is still unknown,let alone the excess risks(ERs)in hospital admissions for CKD due to high PM level exposure.In this study,a two-stage time-stratified case-crossover study was conducted to investigate the association of ambient air PM exposure with hospital admission for CKD in 282 Chinese cities of prefecture-level or above during 2013–2017.City-specific associations of single and cumulative 0–3 days lagged exposure to fine particulate matter(PM_(2.5))and inhalable particles(PM_(10))with hospital admissions for total CKD and its subtypes were evaluated by the conditional logistic regression model,then were pooled using the random-effect model.A total of 3,490,416 hospital admissions for CKD were identified.We found that per interquartile range(IQR)increment in PM_(2.5) at lag02 and per IQR increment in PM_(10) at lag03 were associated with increases of 2.36%(95%CI:1.58%,3.14%)and 2.87%(95%CI:1.91%,3.85%)in hospital admissions for total CKD,respectively.Compared to control concentrations(PM_(2.5):35μg/m^(3);PM_(10):50μg/m^(3)),the largest ERs in hospital admissions for total CKD were 2.63%(95%CI:2.15%–3.11%)and 4.45%(95%CI:3.85%–5.06%)in association with exposure to heavily excessive PM_(2.5)(≥75μg/m^(3))and PM_(10)(≥150μg/m^(3)),respectively.Moreover,the attributable fractions(AFs)for CKD admissions were 2.83%for PM_(2.5) and 3.46%for PM_(10) during the study period.These findings suggested that exposure to PM_(2.5) and PM_(10) is associated with substantially increased risk and burden of CKD admissions.
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.
文摘Aim： To compare the use of the suprapubic puncture method versus the transurethral method in pressure-flow studies in patients with benign prostatic hyperplasia. Methods： Twenty-three men with benign prostatic hyperplasia underwent both suprapubic and transurethral pressure-flow studies during a single session. Standard pressure-flow variables were recorded in all patients with both methods, enabling calculation of obstruction using commonly used grading systems, such as the urethral resistance algorithm, the Abrams-Griffith （AG） number and the Schaefer linear nomogram. Results： There were statistically significant differences between the methods in the mean values of maximum flow rate （P 〈 0.05）, detrusor pressure at the maximum flow （P 〈 0.01）, urethral resistance algorithm （P 〈 0.01）, AG number （P 〈 0.01） and maximum cystic capacity （P 〈 0.01）. Of the men in the study, 10 （43.5%） remained in the same Schaefer class with both methods and 18 （78.3%） in the same AG number area. Using the transurethral method, 12 （52.2%） men increased their Schaefer class by one and 1 （4.3%） by two. There were also differences between the suprapubic and transurethral methods using the AG number： 4 （17.4%） men moved from a classification of equivocal to obstructed and 1 （4.3%） from unobstructed to equivocal. Conclusion： The differences between the techniques for measuring intravesical pressure alter the grading of obstruction determined by several of the commonly used classifications. An 8 F transurethral catheter significantly increases the likelihood of a diagnosis of bladder outlet obstruction when compared with the suprapubic method.
