BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery...BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery speed and quality of life.Effective prevention of anxiety and depression in elderly patients has become an urgent problem.AIM To investigate the trajectory of anxiety and depression levels in elderly patients after LIF,and the influencing factors.METHODS Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital.General information and surgery-related indices were recorded,and participants completed measures of psychological status,lumbar spine dysfunction,and quality of life.A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels,and unordered multi-categorical logistic regression was used to analyze the influencing factors.RESULTS Three trajectories of change in anxiety level were identified:Increasing anxiety(n=26,10.88%),decreasing anxiety(n=27,11.30%),and stable anxiety(n=186,77.82%).Likewise,three trajectories of change in depression level were identified:Increasing depression(n=30,12.55%),decreasing depression(n=26,10.88%),and stable depression(n=183,76.57%).Regression analysis showed that having no partner,female sex,elevated Oswestry dysfunction index(ODI)scores,and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels,whereas female sex,postoperative opioid use,and elevated ODI scores all contributed to increased depression levels.CONCLUSION During clinical observation,combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention,quickens recovery,and enhances quality of life.展开更多
Background Cardiovascular disease(CVD)and frailty are interrelated conditions prevalent in aging populations,yet their dynamic temporal relationship remains underexplored.This study investigates longitudinal changes i...Background Cardiovascular disease(CVD)and frailty are interrelated conditions prevalent in aging populations,yet their dynamic temporal relationship remains underexplored.This study investigates longitudinal changes in frailty trajectories before and after incident CVD across diverse cohorts.Methods Utilizing data from four longitudinal,multinational cohorts(ELSA,HRS,CHARLS,SHARE;n=66,537),we constructed the frailty index(FI)based on age-related health deficits,using 40,40,42,and 44 items from ELSA,HRS,CHARLS and SHARE,respectively.Linear mixed models assessed FI changes pre-and post-CVD,adjusting for demographics,lifestyle,and baseline FI.Sensitivity analyses excluded hypertension,diabetes,and arthritis to mitigate confounding.Results Frailty increased steadily before CVD onset(pre-CVD slope:ELSAβ=0.005,HRSβ=0.005,CHARLSβ=0.012,SHAREβ=0.007;all P<0.001),with an acute FI spike at diagnosis(post-CVD acute change:ELSAβ=0.024,HRSβ=0.031,CHARLSβ=0.046,SHAREβ=0.038;all P<0.001).Post-CVD,frailty progression further accelerated(ELSAβ=0.008,HRSβ=0.005,CHARLSβ=0.017,SHAREβ=0.010;all P<0.001).Sensitivity analyses confirmed robustness across age strata and FI definitions.Conclusions This first multinational study demonstrates bidirectional acceleration of frailty around CVD onset,highlighting their close temporal interplay.These findings suggest that incorporating frailty assessment into CVD management may help identify high-risk individuals and support timely,multidimensional care in aging populations.展开更多
Understanding wetland change is critical to establishing and implementing international conservation and management conventions.With such knowledge,supporting sustainable development,making management decisions,improv...Understanding wetland change is critical to establishing and implementing international conservation and management conventions.With such knowledge,supporting sustainable development,making management decisions,improving policies,and conducting scientific research become possible.However,consistent information on changes in Chinese wetlands has been unavailable.We applied the hybrid object-based and hierarchical classification approach to∼53,000 scenes of Landsat images acquired between 1980 and 2020 and created a national wetland mapping product(China_Wetlands)for six periods(e.g.,1980,1990,2000,2010,2015,and 2020).China_Wetlands revealed diverse changes in Chinese wetlands and their trajectories in response to climate change and human impacts over the past four decades.Specifically,there was a substantial shrinkage in wetland area before 2015,with a small rebound between 2015 and 2020.The net loss was∼60.9×10^(3)km^(2),which represents 12%of the area in 1980.However,the loss of natural wetlands was hidden by human-made wetland gain with an offset of 15.6×10^(3)km^(2).Additionally,the expansion of surface water extent approximately 14.0×10^(3)km^(2)obscured the loss of vegetated wetlands.Wetland loss in hotspot areas(e.g.,Sanjiang Plain and Yangtze River Delta)should not be neglected.The sustainable management and effective conservation of wetlands in China should target wetland areas,landscape structures,and small wetlands delivering important ecosystem services.Moreover,the conversion of wetland types and the invasion of alien species need to be monitored and regulated.China_Wetlands will be a critical wetland dataset for ecological research and the assessment of national and global environmental objectives(e.g.,the United Nation’s sustainable development goals).展开更多
National nature reserves are an important part of classification management on ecological protection in China. Taking the national nature reserves of Jilin Province as examples, this paper introduced the stability ind...National nature reserves are an important part of classification management on ecological protection in China. Taking the national nature reserves of Jilin Province as examples, this paper introduced the stability index by referring to the intensity model of landuse and land-cover change(LUCC), and analyzed the overall stability of land-use and land-cover(LULC) in the study area from the time interval level and land category level. The stability of LULC in different types of nature reserves was tracked and identified by extracting land-use change trajectory, and the land-use change trajectory was divided into three types: stable type, sub-stable type and unstable type. The impact of LUCC on regional ecosystem services was studied by using hotspot analysis and gravity center analysis. The results showed that: 1) The LULC in the study area was stable on the whole, and the proportion of stable land area reached 86.08%. The intensity of LUCC showed an increasing trend in recent 20 years, and the conversion of cultivated land and construction land was active in continuous time interval. 2) The stability of LULC in forest ecological reserves and wildlife reserves in the eastern part of Jilin Province was the highest, while that in inland wetland reserves and geological relic reserves in the central and western part of Jilin Province was lower.3) The LUCC in national nature reserves not only changed the value of its own ecosystem service function, but also affected the ecosystem service function of the whole region. The combination of intensity analysis and land-use change trajectory was used to identify the characteristics of stability of LULC in nature reserves, which was conducive to deeply understand the process of LUCC in national nature reserves and provided reasonable suggestions for regional ecological protection.展开更多
Objective： To understand the changing trajectory of quality of life（QOL） during the treatment courses of breast cancer patients during chemotherapy and to investigate the factors in each treatment course that affec...Objective： To understand the changing trajectory of quality of life（QOL） during the treatment courses of breast cancer patients during chemotherapy and to investigate the factors in each treatment course that affect QOL.Methods： The M.D. Anderson Symptom Inventory Scale, the Hospital Anxiety and Depression Scale（HADS）, and the Functional Assessment of Cancer Therapy-Breast（FACT-B） scale were used to perform a survey on 174 breast cancer patients who received the TAC（docetaxel, Adriamycin, and cyclophosphamide） chemotherapy regimen before postoperative chemotherapy and 5-7 days after each chemotherapy course.Results： The QOL scores of the breast cancer patients were the lowest before the postoperative chemotherapy（81.2 ± 19.6） and the highest after the second chemotherapy course（94.5 ± 14.4）. After the fourth and fifth chemotherapy courses, the scores were much lower again, with values of 82.7 ± 13.9and 82.6 ± 13.1, respectively. The scores improved again after the sixth chemotherapy course（93.9 ± 18.7）. Furthermore, each treatment course had different related symptoms that affected the QOL of the patients.Conclusions： More attention should be paid to the changing trajectory of QOL of patients in all treatment courses and to the influence of treatment-related symptoms on the QOL of patients; moreover, interventions should be adopted by medical care personnel to increase QOL in cancer patients.展开更多
基金Supported by the Scientific Research Projects of the Health System in Pingshan District,No.2023122.
文摘BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery speed and quality of life.Effective prevention of anxiety and depression in elderly patients has become an urgent problem.AIM To investigate the trajectory of anxiety and depression levels in elderly patients after LIF,and the influencing factors.METHODS Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital.General information and surgery-related indices were recorded,and participants completed measures of psychological status,lumbar spine dysfunction,and quality of life.A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels,and unordered multi-categorical logistic regression was used to analyze the influencing factors.RESULTS Three trajectories of change in anxiety level were identified:Increasing anxiety(n=26,10.88%),decreasing anxiety(n=27,11.30%),and stable anxiety(n=186,77.82%).Likewise,three trajectories of change in depression level were identified:Increasing depression(n=30,12.55%),decreasing depression(n=26,10.88%),and stable depression(n=183,76.57%).Regression analysis showed that having no partner,female sex,elevated Oswestry dysfunction index(ODI)scores,and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels,whereas female sex,postoperative opioid use,and elevated ODI scores all contributed to increased depression levels.CONCLUSION During clinical observation,combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention,quickens recovery,and enhances quality of life.
基金Natural Science Foundation of Shandong Province(Grant No.ZR2021QH176)。
文摘Background Cardiovascular disease(CVD)and frailty are interrelated conditions prevalent in aging populations,yet their dynamic temporal relationship remains underexplored.This study investigates longitudinal changes in frailty trajectories before and after incident CVD across diverse cohorts.Methods Utilizing data from four longitudinal,multinational cohorts(ELSA,HRS,CHARLS,SHARE;n=66,537),we constructed the frailty index(FI)based on age-related health deficits,using 40,40,42,and 44 items from ELSA,HRS,CHARLS and SHARE,respectively.Linear mixed models assessed FI changes pre-and post-CVD,adjusting for demographics,lifestyle,and baseline FI.Sensitivity analyses excluded hypertension,diabetes,and arthritis to mitigate confounding.Results Frailty increased steadily before CVD onset(pre-CVD slope:ELSAβ=0.005,HRSβ=0.005,CHARLSβ=0.012,SHAREβ=0.007;all P<0.001),with an acute FI spike at diagnosis(post-CVD acute change:ELSAβ=0.024,HRSβ=0.031,CHARLSβ=0.046,SHAREβ=0.038;all P<0.001).Post-CVD,frailty progression further accelerated(ELSAβ=0.008,HRSβ=0.005,CHARLSβ=0.017,SHAREβ=0.010;all P<0.001).Sensitivity analyses confirmed robustness across age strata and FI definitions.Conclusions This first multinational study demonstrates bidirectional acceleration of frailty around CVD onset,highlighting their close temporal interplay.These findings suggest that incorporating frailty assessment into CVD management may help identify high-risk individuals and support timely,multidimensional care in aging populations.
基金funded by the National Natural Science Foundation of China(42222103,42171379,and 42101379)the Open Research Program of the International Research Center of Big Data for Sustainable Development Goals(CBAS2023ORP04)the Youth Innovation Promotion Association of Chinese Academy of Sciences(2017277).
文摘Understanding wetland change is critical to establishing and implementing international conservation and management conventions.With such knowledge,supporting sustainable development,making management decisions,improving policies,and conducting scientific research become possible.However,consistent information on changes in Chinese wetlands has been unavailable.We applied the hybrid object-based and hierarchical classification approach to∼53,000 scenes of Landsat images acquired between 1980 and 2020 and created a national wetland mapping product(China_Wetlands)for six periods(e.g.,1980,1990,2000,2010,2015,and 2020).China_Wetlands revealed diverse changes in Chinese wetlands and their trajectories in response to climate change and human impacts over the past four decades.Specifically,there was a substantial shrinkage in wetland area before 2015,with a small rebound between 2015 and 2020.The net loss was∼60.9×10^(3)km^(2),which represents 12%of the area in 1980.However,the loss of natural wetlands was hidden by human-made wetland gain with an offset of 15.6×10^(3)km^(2).Additionally,the expansion of surface water extent approximately 14.0×10^(3)km^(2)obscured the loss of vegetated wetlands.Wetland loss in hotspot areas(e.g.,Sanjiang Plain and Yangtze River Delta)should not be neglected.The sustainable management and effective conservation of wetlands in China should target wetland areas,landscape structures,and small wetlands delivering important ecosystem services.Moreover,the conversion of wetland types and the invasion of alien species need to be monitored and regulated.China_Wetlands will be a critical wetland dataset for ecological research and the assessment of national and global environmental objectives(e.g.,the United Nation’s sustainable development goals).
基金Under the auspices of National Natural Science Foundation of China(No.42071255)。
文摘National nature reserves are an important part of classification management on ecological protection in China. Taking the national nature reserves of Jilin Province as examples, this paper introduced the stability index by referring to the intensity model of landuse and land-cover change(LUCC), and analyzed the overall stability of land-use and land-cover(LULC) in the study area from the time interval level and land category level. The stability of LULC in different types of nature reserves was tracked and identified by extracting land-use change trajectory, and the land-use change trajectory was divided into three types: stable type, sub-stable type and unstable type. The impact of LUCC on regional ecosystem services was studied by using hotspot analysis and gravity center analysis. The results showed that: 1) The LULC in the study area was stable on the whole, and the proportion of stable land area reached 86.08%. The intensity of LUCC showed an increasing trend in recent 20 years, and the conversion of cultivated land and construction land was active in continuous time interval. 2) The stability of LULC in forest ecological reserves and wildlife reserves in the eastern part of Jilin Province was the highest, while that in inland wetland reserves and geological relic reserves in the central and western part of Jilin Province was lower.3) The LUCC in national nature reserves not only changed the value of its own ecosystem service function, but also affected the ecosystem service function of the whole region. The combination of intensity analysis and land-use change trajectory was used to identify the characteristics of stability of LULC in nature reserves, which was conducive to deeply understand the process of LUCC in national nature reserves and provided reasonable suggestions for regional ecological protection.
基金supported by a project of scientific research of the Affiliated Hospital of Luzhou Medical College(No.14039)
文摘Objective： To understand the changing trajectory of quality of life（QOL） during the treatment courses of breast cancer patients during chemotherapy and to investigate the factors in each treatment course that affect QOL.Methods： The M.D. Anderson Symptom Inventory Scale, the Hospital Anxiety and Depression Scale（HADS）, and the Functional Assessment of Cancer Therapy-Breast（FACT-B） scale were used to perform a survey on 174 breast cancer patients who received the TAC（docetaxel, Adriamycin, and cyclophosphamide） chemotherapy regimen before postoperative chemotherapy and 5-7 days after each chemotherapy course.Results： The QOL scores of the breast cancer patients were the lowest before the postoperative chemotherapy（81.2 ± 19.6） and the highest after the second chemotherapy course（94.5 ± 14.4）. After the fourth and fifth chemotherapy courses, the scores were much lower again, with values of 82.7 ± 13.9and 82.6 ± 13.1, respectively. The scores improved again after the sixth chemotherapy course（93.9 ± 18.7）. Furthermore, each treatment course had different related symptoms that affected the QOL of the patients.Conclusions： More attention should be paid to the changing trajectory of QOL of patients in all treatment courses and to the influence of treatment-related symptoms on the QOL of patients; moreover, interventions should be adopted by medical care personnel to increase QOL in cancer patients.
