Acute respiratory distress syndrome(ARDS)is a life-threatening condition that is characterized by high mortality rates and limited therapeutic options.Notably,Zhang et al demonstrated that CD146+mesenchymal stromal ce...Acute respiratory distress syndrome(ARDS)is a life-threatening condition that is characterized by high mortality rates and limited therapeutic options.Notably,Zhang et al demonstrated that CD146+mesenchymal stromal cells(MSCs)exhibited greater therapeutic efficacy than CD146-MSCs.These cells enhance epithelial repair through nuclear factor kappa B/cyclooxygenase-2-associated paracrine signaling and secretion of pro-angiogenic factors.We concur that MSCs hold significant promise for ARDS treatment;however,the heterogeneity of cell products is a translational barrier.Phenotype-aware strategies,such as CD146 enrichment,standardized potency assays,and extracellular vesicle profiling,are essential for improving the consistency of these studies.Further-more,advanced preclinical models,such as lung-on-a-chip systems,may provide more predictive insights into the therapeutic mechanisms.This article underscores the importance of CD146+MSCs in ARDS,emphasizes the need for precision in defining cell products,and discusses how integrating subset selection into translational pipelines could enhance the clinical impact of MSC-based therapies.展开更多
Acute respiratory distress syndrome(ARDS)is a severe clinical condition characterized by acute respiratory failure due to widespread pulmonary inflammation and edema.The incidence of ARDS among intensive care unit(ICU...Acute respiratory distress syndrome(ARDS)is a severe clinical condition characterized by acute respiratory failure due to widespread pulmonary inflammation and edema.The incidence of ARDS among intensive care unit(ICU)patients is approximately 10%,with mortality rates ranging from 35%to 45%and exceeding 50%in severe cases.[1]Identifying and controlling risk factors for ARDS is critical for early prevention.Smoking remains a significant global public health issue,affecting one-third of adults and 40%of children through exposure to secondhand smoke.[2]In an animal study,cigarette smoke impaired lung endothelial barrier function through oxidative stress and exacerbated lipopolysaccharide-induced increases in vascular permeability in vivo.This finding is consistent with the pathological changes observed in ARDS.[3]Although many observational studies have suggested a potential link between smoking and ARDS,the causal relationship remains unclear.This study uses Mendelian randomization(MR)to explore whether smoking behavior causally influences ARDS and investigates the mechanisms by which smoking may contribute to ARDS development through transcriptomic analysis of the Gene Expression Omnibus(GEO)database.展开更多
Purpose:This study aimed to determine the nurses’profile characteristics that are associated with moral distress among nurses in selected government hospitals in Shangdong,China.Methods:This is a descriptive-correlat...Purpose:This study aimed to determine the nurses’profile characteristics that are associated with moral distress among nurses in selected government hospitals in Shangdong,China.Methods:This is a descriptive-correlational study.A total of 185 clinical registered nurses who met the eligibility criteria from different departments in two tertiary governmental hospitals in Jinan city were purposively selected to participate in this study.The instruments included the general demographic characteristics and Chinese version of Moral Distress Scale-Revised(MDS-R).Correlation technique,specifically Spearman’s rho,was utilized to determine the significant correlation between the selected nurse’s characteristics and moral distress.Ethical considerations were given by the Far Eastern University ethics review committee(FEU-ERC Code:2020-2021-079).Results:The number of patients nurses handled per shift(rs=0.650,p=0.032)and the type of patients that nurses handled(rs=0.718,p=0.020)are the nurses’profile factors that are significantly correlated with nurses’moral distress(p-value<0.05).As there is an increase in the number of patients handled every shift and the patients are becoming unstable,requiring complex care,the frequency and intensity of moral distress increase as well.Conclusion:The nurses’moral distress was registered at a low level in this study.Characteristics related to patients,such as the number and type assigned to nurses,are correlated to moral distress.The main source of the high frequency and intensity of moral distress among nurses is“futile care”and“false hope”.Educational learning program is recommended to manage and alleviate the moral distress of nurses.展开更多
Objectives This study aimed to develop and preliminarily assess the quality of a Mindfulness Breast Care(MBC)App to reduce body image distress and stigma among breast cancer survivors(BCSs).Methods The development pro...Objectives This study aimed to develop and preliminarily assess the quality of a Mindfulness Breast Care(MBC)App to reduce body image distress and stigma among breast cancer survivors(BCSs).Methods The development process of the MBC App involved:1)establishing a research group;2)determining of the content of the MBC App based on Mindfulness-Based Cognitive Therapy and 3)technical exploitation and maintenance.A mixed-methods study was conducted.We selected ten BCSs by a convenience sampling method.After using the APP for three months,five assessed the quality using the Mobile App Rating Scale:User Version(uMARS)and another five were interviewed for process evaluation.Results The MBC App was developed with three modules:1)Library to provide health education information on body image,stigma,mindfulness,recovery and etc;2)Mindfulness Yoga to offer 12 Hatha yoga videos for daily practice;and 3)Mindfulness Practices to have 12 sessions of mindfulness videoconferences.Based on the uMARS data,the MBC App received high ratings for functionality(4.10±0.34),aesthetics(3.93±0.55),information quality(4.10±0.72),and perceived impact(4.03±0.96),as well as moderate ratings for engagement(3.72±0.94)and subjective quality(3.87±0.77).Participants indicated that the MBC App provided reliable knowledge,information,and emotional support.Recommendations from participants included categorizing knowledge in the Library Module,recording videoconferences of mindfulness practice,and adding discussion sessions in the videoconference.Afterward,we optimized the MBC App to enhance the user experience accordingly.Conclusions The MBC App offers online mindfulness interventions specifically for BCSs in China.The preliminary quality assessment indicates that the MBC App may be a promising tool for delivering mindfulness interventions to BCSs.展开更多
Variation in the vocal behavior of nonhuman vertebrates includes graded transitions and more dramatic changes.Wapiti males produce a reproductive bugle that has a fundamental frequency that surpasses 2,000 Hz with evi...Variation in the vocal behavior of nonhuman vertebrates includes graded transitions and more dramatic changes.Wapiti males produce a reproductive bugle that has a fundamental frequency that surpasses 2,000 Hz with evidence of biphonation and other nonlinear phenomena.Here,we analyze the acoustic structure of captive wapiti vocalizations to compare the male bugle with 3 categories of distress vocalizations:neonate distress(capture)calls,calf isolation calls,and adult female isolation calls.These 4 high-arousal call categories serve a common general function in recruiting conspecifics but occur in different behavioral contexts(capture,isolation,reproduction).Our goal was to distinguish characteristics that vary in graded steps that may correspond to an animal’s age or size from characteristics that are unique to the bugle.Characteristics of the high and loud fundamental(G0)varied in an age/size-graded manner with a decrease in minimum G0,an increase in the maximum and range of G0,with no evidence of sex differences.The nonlinear phenomena of deterministic chaos,biphonation,and frequency jumps were present in all 4 call categories and became more common from the distress vocalizations of neonates to calves to adult females to the male bugle.Two temporal characteristics sharply distinguished the bugle from the 3 categories of distress vocalizations:these included a prolonged call duration and a maximum G0 that occurred much later in the call for the bugle than for distress vocalizations.Our results suggest that distress vocalizations of different age groups and the reproductive bugle of wapiti share a high G0,with age/size-graded changes in G0 and nonlinear phenomena,but differ sharply in temporal characteristics.展开更多
BACKGROUND Frailty has become a significant public health issue.The recent increase in the number of frail older adults has led to increased attention being paid to psycho-logical care services in communities.The soci...BACKGROUND Frailty has become a significant public health issue.The recent increase in the number of frail older adults has led to increased attention being paid to psycho-logical care services in communities.The social isolation of pre-frail older adults can impact their psychological distress.AIM To explore the mediating effect of health literacy between social isolation and psychological distress among communitydwelling older adults with pre-frailty.METHODS This descriptive cross-sectional study was conducted with 254 pre-frail older individuals aged 60 years and over.Social isolation,health literacy,and psycholo-gical distress were comprehensively measured using the Lubben Social Network Scale-6,12-item Short-Form Health Literacy Questionnaire,and the Kessler Psy-chological Distress Scale-10.Data were evaluated using the SPSS 27.0 package program and the PROCESS macro tool.Descriptive statistical analyses,correlation analyses,and bootstrap mediation tests were used to assess associations between the variables.RESULTS The results showed that social isolation had an effect on health literacy among pre-frail older adults(β=0.240,P<0.001),social isolation impact on psycho-logical distress pre-frail older adults(β=-0.415,P<0.001);health literacy was identified effect on psychological distress among pre-frail older persons(β=-0.307,P<0.001).Health literacy partially mediated the relationship between social isolation and psychological distress among community-dwelling older adults with pre-frailty,with a mediation effect of-0.074,accounting for 17.83%of the total effect.展开更多
Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major...Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major cause of morbidity and mortality in pediatrics. The aim of our study was to investigate the epidemiological, clinical and therapeutic aspects of respiratory distress in children aged between 1 month and 15 years seen in the emergency department of the Bangui paediatric university hospital. Methodology: This was a 3-month descriptive cross-sectional study, from January 1 to March 31, 2023. All children aged 1 month to less than 15 years presenting with respiratory distress were included. Results: A total of 3021 children were admitted to the emergency medical services of Bangui’s pediatric university hospital. Of these, 164 were included in the study. The predominance was male, with a sex ratio of 1.09. The 0 - 2 age group was the most represented, with 67 patients (42.85%). The majority of patients came from Bangui, accounting for 146 (89.02%) of cases. Respiratory difficulty (59.15%), characterized by dyspnea and cough, associated with fever, vomiting, physical asthenia and diarrhea, were the main reasons for consultation. The main pathologies noted were respiratory 92 (56.10%), followed by cardiac pathologies 21 (12.8%). Antibiotic administration (76.82%) was the most common therapeutic procedure used in the management of respiratory distress. Conclusion: Respiratory distress remains an important cause of infant mortality in our context, with major management problems.展开更多
Background:Acute respiratory distress syndrome(ARDS)is the major therapeutic dilemma associated with significant inflammation and severe pulmonary dysfunction.Liriodendrin is a bioactive compound extract from traditio...Background:Acute respiratory distress syndrome(ARDS)is the major therapeutic dilemma associated with significant inflammation and severe pulmonary dysfunction.Liriodendrin is a bioactive compound extract from traditional Chinesemedicine,historically utilized formodulating inflammatory responses and alleviating symptoms in multiple diseasemodels.Methods:At present,BALB/c mice to explore the effects of liriodendrin on lipopolysaccharide(LPS)-induced ARDS.Before LPS was administered,the mice were treated with either liriodendrin or dexamethasone.Leukocyte infiltration,lung edema,and alveolar-capillary barrier integrity were evaluated in the bronchoalveolar lavage fluid(BALF)and pulmonary parenchyma.The expression of adhesion molecules and proinflammatory cytokines in BALF was evaluated by enzyme-linked immunosorbent assay.Western blotting assay facilitated the analysis of the expression or phosphorylation of inducible nitric oxide synthase(iNOS),cyclooxygenase-2(COX-2),NOD-like receptor family pyrin domain-containing 3(NLRP3),apoptosis-associated speck-like protein containing a CARD(ASC),cleaved caspase-1(CL-csapase-1),nuclear factor kappa-light-chain-enhancer of activated B cells(NF-κB),inhibitor of kappa B(IκB),mitogen-activated protein kinase(MAPK),and protein kinase B(Akt)in the lungs.In addition,the anti-inflammatory effects of liriodendrin were evaluated in LPS-stimulated RAW264.7 macrophages.Before LPS was administered,the RAW264.7 macrophages were treated with either liriodendrin or dexamethasone.Nitric Oxide(NO)production was measured using the Griess reaction assay,while ELISA assessed IL-1β,IL-6,and TNF-αlevels.Western blot analysis evaluated NF-κB phosphorylation and the expression of NLRP3,ASC,and CLcaspase-1.Results:These outcomes revealed that liriodendrin intervention markedly ameliorated the pathological features of LPS-induced ARDS,including leukocyte infiltration,lung edema,and alveolar-capillary barrier disruption.Liriodendrin also reduced the LPS-induced secretion of intercellular adhesion molecule-1(ICAM-1)and vascular cell adhesionmolecule-1(VCAM-1),expression of iNOS and COX2,and production of proinflammatory cytokines.Finally,we further discovered that the concentration trend of liriodendron amelioration ofARDSwas similar to those ofNLRP3 formation,NF-κB pathway activation,and p38 MAPK,c-Jun N-terminal kinase(JNK),and Akt phosphorylation but not to that of extracellular signal-regulated kinase(ERK)phosphorylation.Liriodendrin inhibited LPS-induced inflammatory responses in RAW264.7 macrophages.It markedly reduced NO production,propro-inflammatorytokines,NF-κB phosphorylation,and NLRP3 formation.Conclusions:In summary,liriodendrin effectively ameliorated the pathological features of LPS-induced ARDS inmice,demonstrating significant anti-inflammatory properties attributed to NLRP3 formation through NF-κB pathway activation by p38MAPK,JNK,and Akt phosphorylation.In LPS-treated RAW264.7 macrophages,liriodendrin reduced NO production,pro-inflammatory cytokines,and NLRP3 formation,suggesting its potential as an agent for ARDS and relative inflammation.展开更多
Thyroid cancer is a common endocrine malignancy with a rising incidence.Pa-tients often suffer from mental pain due to concerns about recurrence,treatment-related side-effect,and body image changes.Demographic factors...Thyroid cancer is a common endocrine malignancy with a rising incidence.Pa-tients often suffer from mental pain due to concerns about recurrence,treatment-related side-effect,and body image changes.Demographic factors like age,gender,physiological factors such as somatic symptoms and disease stage,co-gnitive-regulatory factors including negative and positive thinking,and social factors like work,economy,education level,and social support all influence their mental state.Existing interventions,including nursing,psychological,and tra-ditional Chinese medicine-based methods,have some benefits but face limitations like short-term effectiveness and lack of standardization.Future research should focus on creating better-defined,long-term,and widely applicable intervention programs and explore positive psychology-based approaches to improve patients'mental well-being and quality of life.展开更多
Objectives:The study aimed to examine the severity of moral distress and intention to leave among ICU nurses in the United Arab Emirates(UAE),and explore the influencing factors of intention to leave.Methods:The study...Objectives:The study aimed to examine the severity of moral distress and intention to leave among ICU nurses in the United Arab Emirates(UAE),and explore the influencing factors of intention to leave.Methods:The study utilized a cross-sectional research design.A convenience non-probability sample of 341 nurses from various private and government hospitals across different emirates in the UAE participated in June 2022.Data were collected using a self-administered questionnaire comprising demographic information,the Moral Distress Scale–Revised.Multivariable logistic regression was used to identify factors associated with intention to leave.Results:The study found that a large majority(71.9%)of ICU nurses experienced severe moral distress,and more than 35%had intention to leave.Futile end-of-life interventions emerged as the most distress-provoking aspect of practice[16.0(0,16.0)].Multivariable analysis revealed nurses experiencing severe moral distress had 3.73 times the odds of intending to leave their job compared with those experiencing mild distress(95%CI:1.81,7.69;P<0.001)and being aged 31–40 years(OR=2.02;95%CI:1.23,3.33;P=0.005)was independently associated with a higher intention to leave.Conclusions:Severe moral distress was prevalent among ICU nurses in the UAE and strongly associated with intention to leave,and also those aged 31–40 years.Promoting ethical support,shared decision-making,and nurse empowerment is vital to improving retention and care quality.展开更多
BACKGROUND Diabetes distress(DD),an emotional problem arising from the challenges of living with diabetes and the relentless burden of daily self-management,is common among patients with type 2 diabetes(T2D).South Asi...BACKGROUND Diabetes distress(DD),an emotional problem arising from the challenges of living with diabetes and the relentless burden of daily self-management,is common among patients with type 2 diabetes(T2D).South Asia has a high T2D burden,and many studies have reported varying prevalence rates of DD in this area.AIM To estimate the pooled prevalence of DD among patients with T2D in South Asia,as it is crucial for developing effective therapeutic strategies.METHODS This systematic review and meta-analysis included cross-sectional studies conducted in South Asian countries involving adults with T2D and reported the prevalence of DD.The studies were identified by searching multiple electronic databases and registries from the inception of each database to January 30,2025,using prespecified search terms.Four authors screened and extracted data independently.Meta-analyses were conducted using RStudio software with a random-effects model.The primary outcome was the pooled prevalence of DD.RESULTS Thirty-seven cross-sectional studies(28 from India,five from Bangladesh,and two each from Pakistan and Sri Lanka)with mostly high methodological quality involving 11500 subjects were included.The pooled prevalence of DD was 44%(95%confidence interval:35-53,I2=97.4%).The prevalence of DD was highest in Pakistan(85%),followed by India and Bangladesh(42%each),and Sri Lanka(25%).Emotional burden was the most prevalent form of DD(60%),followed by treatment regimen-related distress(51%),interpersonal distress(31%),and physician-related distress(17%).Meta-regression analysis revealed no significant associations between the prevalence of DD and publication year,sample size,proportion of females,age,duration of diabetes,insulin usage,glycated hemoglobin levels,or diabetic complications.CONCLUSION South Asians with T2D seem to experience a relatively high burden of DD,and the emotional burden is the most common form of DD in this area.Larger studies utilizing unique tools and involving a broader participant base from the region would provide better epidemiological data for effectively planning high-quality diabetes care in South Asian countries.展开更多
Pavement distress detection plays a pivotal role in ensuring roadway safety,serviceability,and cost-effective infrastructure management.With rapid advancements in intelligent transportation systems,computer vision,and...Pavement distress detection plays a pivotal role in ensuring roadway safety,serviceability,and cost-effective infrastructure management.With rapid advancements in intelligent transportation systems,computer vision,and sensing technologies,non-contact detection approaches based on images and point clouds have become increasingly prominent due to their efficiency,objectivity,and scalability.This review systematically examines both image-based and point cloud-based methodologies,structured along the complete detection pipeline encompassing data acquisition,preprocessing,distress extraction,and geometric quantification.Image-based techniques rely on visual cues,such as texture,color,and edge continuity,to identify surface-level anomalies efficiently,benefiting from mature deep learning frameworks for classification,object detection,and pixel-level segmentation.In contrast,point cloud-based methods capture rich three-dimensional geometric and structural information,enabling detailed modeling of crack depth,rutting deformation,and surface irregularities.Although each modality can independently achieve satisfactory performance,their complementary strengths have driven a growing trend toward hybrid frameworks,combining image-based rapid screening with point cloud-based precision modeling,to enhance detection accuracy,robustness,and adaptability across varying conditions.Furthermore,this paper highlights persistent challenges,including multimodal data fusion,high equipment and labeling costs,computational complexity,and the need for standardized benchmarks.By synthesizing current progress and identifying key technical bottlenecks,this review provides a comprehensive foundation and forward-looking perspective for developing intelligent,efficient,and scalable pavement distress detection systems.展开更多
Acute respiratory distress syndrome(ARDS)is a severe and life-threatening manifestation of acute lung injury,characterized by widespread pulmonary inflammation and edema,ultimately resulting in acute respiratory failu...Acute respiratory distress syndrome(ARDS)is a severe and life-threatening manifestation of acute lung injury,characterized by widespread pulmonary inflammation and edema,ultimately resulting in acute respiratory failure.Despite advancements in mechanical ventilation and lung-protective strategies,targeted therapies aimed at modulating dysregulated inflammation and promoting tissue repair remain elusive.Extracellular vesicles(EVs),critical mediators of intercellular communication,have emerged as a promising research focus due to their dual regulatory roles in ARDS pathogenesis.Pro-inflammatory EVs,derived from pathogens or injury-stressed cells,exacerbate alveolar macrophage activation and increase endothelial permeability,thereby aggravating pulmonary damage.In contrast,anti-inflammatory EVs originating from mesenchymal stem cells facilitate alveolar barrier restoration and tissue repair by delivering reparative molecular cargo.This review systematically evaluates the dualistic functions of EVs in ARDS from three key perspectives:Molecular mechanisms,clinical translation,and technical challenges.We further discuss the complexities associated with EV heterogeneity,pathogen interactions,and standardization in EV production.Additionally,we propose future directions that integrate engineered EV modifications and multi-omics approaches to address current therapeutic limitations and enhance ARDS management.展开更多
Financial distress prediction(FDP)is a critical area of study for researchers,industry stakeholders,and regulatory authorities.However,FDP tasks present several challenges,including high-dimensional datasets,class imb...Financial distress prediction(FDP)is a critical area of study for researchers,industry stakeholders,and regulatory authorities.However,FDP tasks present several challenges,including high-dimensional datasets,class imbalances,and the complexity of parameter optimization.These issues often hinder the predictive model’s ability to accurately identify companies at high risk of financial distress.To mitigate these challenges,we introduce FinMHSPE—a novel multi-heterogeneous self-paced ensemble(MHSPE)FDP learning framework.The proposed model uses pairwise comparisons of data from multiple time frames combined with the maximum relevance and minimum redundancy method to select an optimal subset of features,effectively resolving the high dimensionality issue.Furthermore,the proposed framework incorporates the MHSPE model to iteratively identify the most informative majority class data samples,effectively addressing the class imbalance issue.To optimize the model’s parameters,we leverage the particle swarm optimization algorithm.The robustness of our proposed model is validated through extensive experiments performed on a financial dataset of Chinese listed companies.The empirical results demonstrate that the proposed model outperforms existing competing models in the field of FDP.Specifically,our FinMHSPE framework achieves the highest performance,achieving an area under the curve(AUC)value of 0.9574,considerably surpassing all existing methods.A comparative analysis of AUC values further reveals that FinMHSPE outperforms state-of-the-art approaches that rely on financial features as inputs.Furthermore,our investigation identifies several valuable features for enhancing FDP model performance,notably those associated with a company’s information and growth potential.展开更多
Objective:To explore the correlation between disease uncertainty and psychological distress in hospitalized patients with primary liver cancer,providing a basis for clinical nursing interventions.Methods:A convenient ...Objective:To explore the correlation between disease uncertainty and psychological distress in hospitalized patients with primary liver cancer,providing a basis for clinical nursing interventions.Methods:A convenient sampling method was used to select 82 patients with primary liver cancer from a tertiary first-class hospital in Guangzhou from September 2023 to March 2024 as the research subjects.General information questionnaires,the Mishel Uncertainty in Illness Scale-Adult Version(MUIS-A),and the Kessler Psychological Distress Scale(K10)were used for investigation.Pearson correlation analysis and linear regression analysis were performed to explore the relationship between the two.Results:The total score of disease uncertainty in hospitalized patients with primary liver cancer was(99.20±8.79),and the total score of psychological distress was(22.87±9.46),both at a medium level.There was a positive correlation between disease uncertainty and psychological distress(r=0.360,P<0.01),and the ambiguity dimension had the strongest correlation with psychological distress(r=0.399,P<0.01).Regression analysis showed that the ambiguity dimension had a significant predictive effect on psychological distress(β=0.399,P<0.01).Conclusion:There is a close correlation between disease uncertainty and psychological distress in patients with primary liver cancer.In clinical nursing,it is necessary to pay special attention to patients’ambiguity regarding disease symptoms and prognosis.Targeted health education should be carried out to reduce their uncertainty,thereby improving their psychological state.展开更多
Autophagy plays a pivotal role in the development and resolution of sepsis-induced acute respiratory distress syndrome(S-ARDS),a critical condition characterized by severe inflammation,oxidative stress,apoptosis,and i...Autophagy plays a pivotal role in the development and resolution of sepsis-induced acute respiratory distress syndrome(S-ARDS),a critical condition characterized by severe inflammation,oxidative stress,apoptosis,and immune dysfunction.Traditional Chinese medicine(TCM)has emerged as a promising complementary therapy that modulates autophagy-related pathways.This review summarizes recent advances in understanding how TCM regulates autophagy to alleviate S-ARDS pathology.We highlight the mechanisms by which TCM influences autophagy to modulate inflammation,redox balance,programmed cell death,and immune responses.The integration of historical wisdom and modern molecular insights offers new therapeutic directions for S-ARDS treatment.展开更多
BACKGROUND Grief counseling has become relatively established and is widely used among the families of cancer patients,effectively alleviating their psychological pain.However,in China,due to the influence of Confucia...BACKGROUND Grief counseling has become relatively established and is widely used among the families of cancer patients,effectively alleviating their psychological pain.However,in China,due to the influence of Confucianism and other traditional cultures,people generally adhere to the belief of“reincarnation to avoid death”,focusing more on themes of life,such as eugenics and longevity,and paying less attention to matters related to death,including death education and grief counseling.Currently,grief counseling in China is still in an exploratory stage,and there is relatively little research on the psychological status of family members of patients with terminal tumors.AIM To investigate the psychological effects of grief counseling on family members of terminal cancer patients.METHODS This study was designed as a randomized controlled trial that utilized convenience sampling to select family members of terminal tumor patients who were admitted to the hospice ward of the Affiliated Hospital of Jiangnan University from January to June 2025 as research subjects.All participants received conventional symptomatic supportive treatment and palliative care.Additionally,the intervention group benefited from extra grief counseling.RESULTS The Distress Thermometer(DT)score of the control group slightly decreased compared to before the intervention,but the difference was not statistically significant(P>0.05).In contrast,the DT score of the intervention group decreased significantly compared to before the intervention,with a statistically significant difference(P<0.05).After the intervention,the DT score of the intervention group was lower than that of the control group,and the difference was also statistically significant(P<0.05).After the intervention,the intervention group performed better DT level than the control group,with a statistically significant difference(P<0.05),the intervention group outperformed the control group in terms of depression and anxiety,and the difference was statistically significant(P<0.05).CONCLUSION Grief counseling can help alleviate the psychological pain and negative emotions experienced by family members of patients with terminal malignant tumors.展开更多
BACKGROUND Mesenchymal stem cells(MSCs),as a living bio-drug,are being considered as a potential treatment for coronavirus disease 2019(COVID-19)-induced acute res-piratory distress syndrome(ARDS)due to their immunomo...BACKGROUND Mesenchymal stem cells(MSCs),as a living bio-drug,are being considered as a potential treatment for coronavirus disease 2019(COVID-19)-induced acute res-piratory distress syndrome(ARDS)due to their immunomodulatory and repa-rative properties.AIM To synthesize the existing evidence on MSCs and their derivative exosomes for treating COVID-19-induced ARDS,with a focus on the key outcomes of safety and efficacy.METHODS Four databases were systematically searched for randomized controlled trials assessing MSCs and their derived exosomes for COVID-19-induced ARDS trea-tment.Their safety and efficacy were evaluated based on the duration of mecha-nical ventilation,hospital and intensive care unit stay,6-minute walk distance,mortality rates,and adverse events.Weighted mean differences and odds ratios with 95%confidence intervals(CIs)were calculated to estimate treatment out-comes:A network meta-analysis(NMA)evaluated mortality,adverse events,and the number of ventilation-free days.RESULTS Sixteen randomized controlled trials involving 1027 ARDS patients were in-cluded,with 574 receiving MSCs or MSC-derived exosomes.MSC-based therapy did not significantly improve mechanical ventilation duration,ventilation-free days,hospital or intensive care unit stay,or 6-minute walk distance.Sensitivity analysis revealed a significant reduction in mechanical ventilation duration when excluding an outlier(weighted mean difference:-4.84 days;95%CI:-8.21 to-1.47;I2=20%).In contrast,no significant differences were observed in the other outcomes.Mortality and adverse events were comparable between the groups(odds ratio for mortality:0.77;95%CI:0.56-1.06).An NMA of ventilation-free days,mortality,and adverse events revealed no significant difference among MSCs,exosomes,and controls.Exosomes ranked highest in terms of probability of benefit,although without statistical significance.CONCLUSION MSC and exosome-based therapies were found to be safe and associated with a reduced duration of mechanical ventilation in patients with ARDS.NMA showed that exosome-based therapy matched the benefits of its parent cells,but with practical and logistical advantages.展开更多
BACKGROUND Chronic kidney disease(CKD)is an incapacitating illness associated with distressing symptoms(DS)that have negative impact on patients’health-related quality of life(HRQOL).AIM To assess the severity of DS ...BACKGROUND Chronic kidney disease(CKD)is an incapacitating illness associated with distressing symptoms(DS)that have negative impact on patients’health-related quality of life(HRQOL).AIM To assess the severity of DS and their relationships with HRQOL among patients with CKD in Jordan.METHODS A descriptive cross-sectional design was used.A convenience sampling approach was used to recruit the participants.Patients with CKD(n=140)who visited the outpatient clinics in four hospitals in Amman between November 2021 and December 2021 were included.RESULTS The Edmonton Symptom Assessment System was used to measure the severity of the DS while the Short Form-36 tool was used to measure the HRQOL.Participants’mean age was 50.9(SD=15.14).Most of them were males(n=92,65.7%),married(n=95,67.9%),and unemployed(n=93,66.4%).The highest DS were tiredness(mean=4.68,SD=2.98)and worse well-being(mean=3.69,SD=2.43).The highest HRQOL mean score was for the bodily pain scale with a mean score of 68.50 out of 100(SD=32.02)followed by the emotional well-being scale with mean score of 67.60(SD=18.57).CONCLUSION Patients with CKD had suboptimal HRQOL,physically and mentally.They suffer from multiple DS that have a strong association with diminished HRQOL such as tiredness and depression.Therefore,healthcare providers should be equipped with the essential knowledge and skills to promote individualized strategies that focusing on symptom management.展开更多
Objective:To analyze the value of bedside cranial ultrasonography in the early diagnosis of neonatal brain tissue injury in intrauterine distress.Methods:128 neonates with suspected intrauterine distress admitted to t...Objective:To analyze the value of bedside cranial ultrasonography in the early diagnosis of neonatal brain tissue injury in intrauterine distress.Methods:128 neonates with suspected intrauterine distress admitted to the Yichang Central People’s Hospital from January 2023 to December 2024 were selected as study subjects based on the inclusion and exclusion criteria,and all subjects underwent bedside craniocerebral ultrasonography and MRI,and the results of MRI were used as the gold standard to divide the infants into the brain-injury group(n=31)and the no-brain-injury The children were divided into brain injury group(n=31)and no brain injury group(n=97),and the value of bedside cranial ultrasonography for early diagnosis of brain tissue injury in neonates with intrauterine distress was analyzed.Results:(1)Among the 128 cases of intrauterine distress neonates,31 cases were examined for abnormal signs,including 22 cases(70.97%)examined by bedside craniocerebral ultrasonography and 28 cases(90.32%)examined by MRI.(2)Bedside cranial ultrasound detected hypoxic-ischemic encephalopathy in 6 cases,accounting for 4.69%,ventricular widening in 2 cases,accounting for 1.56%,intracranial hemorrhage in 8 cases,accounting for 6.25%,periventricular softening of white matter in 5 cases,accounting for 3.91%,and cerebral edema in 1 case,accounting for 0.78%,while MRI detected hypoxic-ischemic encephalopathy in 9 cases,accounting for 7.03%.3 cases of ventricular widening,accounting for 2.34%,4 cases of intracranial hemorrhage,accounting for 3.13%,9 cases of periventricular-intraventricular white matter softening,accounting for 7.03%,and 3 cases of cerebral edema,accounting for 2.34%were examined.Among them,the detection rate of periventricular-intraventricular hemorrhage by bedside cranial ultrasound was significantly higher than that of MRI(P<0.05).Conclusion:The diagnostic value of bedside cranial ultrasound in periventricular-intraventricular hemorrhage is high,but the diagnostic value is not as good as that of MRI in other brain tissue injuries,and clinically appropriate examination protocols can be selected according to the specific types of craniocerebral injuries.展开更多
基金the Scientific and Technological Research Council of Türkiye(TÜBİTAK)Under the International Postdoctoral Research Fellowship Program(2219),No.1059B192400980the National Postdoctoral Research Fellowship Program(2218),No.122C158.
文摘Acute respiratory distress syndrome(ARDS)is a life-threatening condition that is characterized by high mortality rates and limited therapeutic options.Notably,Zhang et al demonstrated that CD146+mesenchymal stromal cells(MSCs)exhibited greater therapeutic efficacy than CD146-MSCs.These cells enhance epithelial repair through nuclear factor kappa B/cyclooxygenase-2-associated paracrine signaling and secretion of pro-angiogenic factors.We concur that MSCs hold significant promise for ARDS treatment;however,the heterogeneity of cell products is a translational barrier.Phenotype-aware strategies,such as CD146 enrichment,standardized potency assays,and extracellular vesicle profiling,are essential for improving the consistency of these studies.Further-more,advanced preclinical models,such as lung-on-a-chip systems,may provide more predictive insights into the therapeutic mechanisms.This article underscores the importance of CD146+MSCs in ARDS,emphasizes the need for precision in defining cell products,and discusses how integrating subset selection into translational pipelines could enhance the clinical impact of MSC-based therapies.
基金funded by the Hunan Provincial Natural Science Foundation of China(2024JJ2038,2024JJ9161)the Central Government Guides Local Science and Technology Development Fund Projects(2024ZYC031)+4 种基金the Hunan Health High-Level Talent Project(R2023073)the National Key Clinical Specialty Scientific Research Project(Z2023114)the Young Doctor Foundation of Hunan Provincial People’s Hospital(BSJJ202209)the Key Cultivation Project of Hunan Provincial People’s Hospital(RS2022A06)the Clinical Research Center for Emergency and Critical Care in Hunan Province(2021SK4011).
文摘Acute respiratory distress syndrome(ARDS)is a severe clinical condition characterized by acute respiratory failure due to widespread pulmonary inflammation and edema.The incidence of ARDS among intensive care unit(ICU)patients is approximately 10%,with mortality rates ranging from 35%to 45%and exceeding 50%in severe cases.[1]Identifying and controlling risk factors for ARDS is critical for early prevention.Smoking remains a significant global public health issue,affecting one-third of adults and 40%of children through exposure to secondhand smoke.[2]In an animal study,cigarette smoke impaired lung endothelial barrier function through oxidative stress and exacerbated lipopolysaccharide-induced increases in vascular permeability in vivo.This finding is consistent with the pathological changes observed in ARDS.[3]Although many observational studies have suggested a potential link between smoking and ARDS,the causal relationship remains unclear.This study uses Mendelian randomization(MR)to explore whether smoking behavior causally influences ARDS and investigates the mechanisms by which smoking may contribute to ARDS development through transcriptomic analysis of the Gene Expression Omnibus(GEO)database.
文摘Purpose:This study aimed to determine the nurses’profile characteristics that are associated with moral distress among nurses in selected government hospitals in Shangdong,China.Methods:This is a descriptive-correlational study.A total of 185 clinical registered nurses who met the eligibility criteria from different departments in two tertiary governmental hospitals in Jinan city were purposively selected to participate in this study.The instruments included the general demographic characteristics and Chinese version of Moral Distress Scale-Revised(MDS-R).Correlation technique,specifically Spearman’s rho,was utilized to determine the significant correlation between the selected nurse’s characteristics and moral distress.Ethical considerations were given by the Far Eastern University ethics review committee(FEU-ERC Code:2020-2021-079).Results:The number of patients nurses handled per shift(rs=0.650,p=0.032)and the type of patients that nurses handled(rs=0.718,p=0.020)are the nurses’profile factors that are significantly correlated with nurses’moral distress(p-value<0.05).As there is an increase in the number of patients handled every shift and the patients are becoming unstable,requiring complex care,the frequency and intensity of moral distress increase as well.Conclusion:The nurses’moral distress was registered at a low level in this study.Characteristics related to patients,such as the number and type assigned to nurses,are correlated to moral distress.The main source of the high frequency and intensity of moral distress among nurses is“futile care”and“false hope”.Educational learning program is recommended to manage and alleviate the moral distress of nurses.
基金supported by the National Natural Science Foundation of China(No.71974162 and No.7231101009).
文摘Objectives This study aimed to develop and preliminarily assess the quality of a Mindfulness Breast Care(MBC)App to reduce body image distress and stigma among breast cancer survivors(BCSs).Methods The development process of the MBC App involved:1)establishing a research group;2)determining of the content of the MBC App based on Mindfulness-Based Cognitive Therapy and 3)technical exploitation and maintenance.A mixed-methods study was conducted.We selected ten BCSs by a convenience sampling method.After using the APP for three months,five assessed the quality using the Mobile App Rating Scale:User Version(uMARS)and another five were interviewed for process evaluation.Results The MBC App was developed with three modules:1)Library to provide health education information on body image,stigma,mindfulness,recovery and etc;2)Mindfulness Yoga to offer 12 Hatha yoga videos for daily practice;and 3)Mindfulness Practices to have 12 sessions of mindfulness videoconferences.Based on the uMARS data,the MBC App received high ratings for functionality(4.10±0.34),aesthetics(3.93±0.55),information quality(4.10±0.72),and perceived impact(4.03±0.96),as well as moderate ratings for engagement(3.72±0.94)and subjective quality(3.87±0.77).Participants indicated that the MBC App provided reliable knowledge,information,and emotional support.Recommendations from participants included categorizing knowledge in the Library Module,recording videoconferences of mindfulness practice,and adding discussion sessions in the videoconference.Afterward,we optimized the MBC App to enhance the user experience accordingly.Conclusions The MBC App offers online mindfulness interventions specifically for BCSs in China.The preliminary quality assessment indicates that the MBC App may be a promising tool for delivering mindfulness interventions to BCSs.
基金The University of Winnipeg and The University of Winnipeg Foundation contributed funding to this research.
文摘Variation in the vocal behavior of nonhuman vertebrates includes graded transitions and more dramatic changes.Wapiti males produce a reproductive bugle that has a fundamental frequency that surpasses 2,000 Hz with evidence of biphonation and other nonlinear phenomena.Here,we analyze the acoustic structure of captive wapiti vocalizations to compare the male bugle with 3 categories of distress vocalizations:neonate distress(capture)calls,calf isolation calls,and adult female isolation calls.These 4 high-arousal call categories serve a common general function in recruiting conspecifics but occur in different behavioral contexts(capture,isolation,reproduction).Our goal was to distinguish characteristics that vary in graded steps that may correspond to an animal’s age or size from characteristics that are unique to the bugle.Characteristics of the high and loud fundamental(G0)varied in an age/size-graded manner with a decrease in minimum G0,an increase in the maximum and range of G0,with no evidence of sex differences.The nonlinear phenomena of deterministic chaos,biphonation,and frequency jumps were present in all 4 call categories and became more common from the distress vocalizations of neonates to calves to adult females to the male bugle.Two temporal characteristics sharply distinguished the bugle from the 3 categories of distress vocalizations:these included a prolonged call duration and a maximum G0 that occurred much later in the call for the bugle than for distress vocalizations.Our results suggest that distress vocalizations of different age groups and the reproductive bugle of wapiti share a high G0,with age/size-graded changes in G0 and nonlinear phenomena,but differ sharply in temporal characteristics.
基金Supported by the Scientific Research Fund of Zhejiang Provincial Education Department,No.Y202351104and Huzhou Science and Technology Plan Project,No.2023GZ67。
文摘BACKGROUND Frailty has become a significant public health issue.The recent increase in the number of frail older adults has led to increased attention being paid to psycho-logical care services in communities.The social isolation of pre-frail older adults can impact their psychological distress.AIM To explore the mediating effect of health literacy between social isolation and psychological distress among communitydwelling older adults with pre-frailty.METHODS This descriptive cross-sectional study was conducted with 254 pre-frail older individuals aged 60 years and over.Social isolation,health literacy,and psycholo-gical distress were comprehensively measured using the Lubben Social Network Scale-6,12-item Short-Form Health Literacy Questionnaire,and the Kessler Psy-chological Distress Scale-10.Data were evaluated using the SPSS 27.0 package program and the PROCESS macro tool.Descriptive statistical analyses,correlation analyses,and bootstrap mediation tests were used to assess associations between the variables.RESULTS The results showed that social isolation had an effect on health literacy among pre-frail older adults(β=0.240,P<0.001),social isolation impact on psycho-logical distress pre-frail older adults(β=-0.415,P<0.001);health literacy was identified effect on psychological distress among pre-frail older persons(β=-0.307,P<0.001).Health literacy partially mediated the relationship between social isolation and psychological distress among community-dwelling older adults with pre-frailty,with a mediation effect of-0.074,accounting for 17.83%of the total effect.
文摘Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major cause of morbidity and mortality in pediatrics. The aim of our study was to investigate the epidemiological, clinical and therapeutic aspects of respiratory distress in children aged between 1 month and 15 years seen in the emergency department of the Bangui paediatric university hospital. Methodology: This was a 3-month descriptive cross-sectional study, from January 1 to March 31, 2023. All children aged 1 month to less than 15 years presenting with respiratory distress were included. Results: A total of 3021 children were admitted to the emergency medical services of Bangui’s pediatric university hospital. Of these, 164 were included in the study. The predominance was male, with a sex ratio of 1.09. The 0 - 2 age group was the most represented, with 67 patients (42.85%). The majority of patients came from Bangui, accounting for 146 (89.02%) of cases. Respiratory difficulty (59.15%), characterized by dyspnea and cough, associated with fever, vomiting, physical asthenia and diarrhea, were the main reasons for consultation. The main pathologies noted were respiratory 92 (56.10%), followed by cardiac pathologies 21 (12.8%). Antibiotic administration (76.82%) was the most common therapeutic procedure used in the management of respiratory distress. Conclusion: Respiratory distress remains an important cause of infant mortality in our context, with major management problems.
基金supported by Chung Shan Medical University and Changhua Christian Hospital(CSMU-CCH-111-08)supported by research grants from the Chung Shan Medical University Hospital,Taichung,Taiwan(CSH-2023-C-023)the National Science and Technology Council,Taiwan,for financially supporting this research under Contract Nos.NSTC 112-2320-B-040-017,NSTC112-2314-B-040-009,and NSTC 112-2320-B-040-011.
文摘Background:Acute respiratory distress syndrome(ARDS)is the major therapeutic dilemma associated with significant inflammation and severe pulmonary dysfunction.Liriodendrin is a bioactive compound extract from traditional Chinesemedicine,historically utilized formodulating inflammatory responses and alleviating symptoms in multiple diseasemodels.Methods:At present,BALB/c mice to explore the effects of liriodendrin on lipopolysaccharide(LPS)-induced ARDS.Before LPS was administered,the mice were treated with either liriodendrin or dexamethasone.Leukocyte infiltration,lung edema,and alveolar-capillary barrier integrity were evaluated in the bronchoalveolar lavage fluid(BALF)and pulmonary parenchyma.The expression of adhesion molecules and proinflammatory cytokines in BALF was evaluated by enzyme-linked immunosorbent assay.Western blotting assay facilitated the analysis of the expression or phosphorylation of inducible nitric oxide synthase(iNOS),cyclooxygenase-2(COX-2),NOD-like receptor family pyrin domain-containing 3(NLRP3),apoptosis-associated speck-like protein containing a CARD(ASC),cleaved caspase-1(CL-csapase-1),nuclear factor kappa-light-chain-enhancer of activated B cells(NF-κB),inhibitor of kappa B(IκB),mitogen-activated protein kinase(MAPK),and protein kinase B(Akt)in the lungs.In addition,the anti-inflammatory effects of liriodendrin were evaluated in LPS-stimulated RAW264.7 macrophages.Before LPS was administered,the RAW264.7 macrophages were treated with either liriodendrin or dexamethasone.Nitric Oxide(NO)production was measured using the Griess reaction assay,while ELISA assessed IL-1β,IL-6,and TNF-αlevels.Western blot analysis evaluated NF-κB phosphorylation and the expression of NLRP3,ASC,and CLcaspase-1.Results:These outcomes revealed that liriodendrin intervention markedly ameliorated the pathological features of LPS-induced ARDS,including leukocyte infiltration,lung edema,and alveolar-capillary barrier disruption.Liriodendrin also reduced the LPS-induced secretion of intercellular adhesion molecule-1(ICAM-1)and vascular cell adhesionmolecule-1(VCAM-1),expression of iNOS and COX2,and production of proinflammatory cytokines.Finally,we further discovered that the concentration trend of liriodendron amelioration ofARDSwas similar to those ofNLRP3 formation,NF-κB pathway activation,and p38 MAPK,c-Jun N-terminal kinase(JNK),and Akt phosphorylation but not to that of extracellular signal-regulated kinase(ERK)phosphorylation.Liriodendrin inhibited LPS-induced inflammatory responses in RAW264.7 macrophages.It markedly reduced NO production,propro-inflammatorytokines,NF-κB phosphorylation,and NLRP3 formation.Conclusions:In summary,liriodendrin effectively ameliorated the pathological features of LPS-induced ARDS inmice,demonstrating significant anti-inflammatory properties attributed to NLRP3 formation through NF-κB pathway activation by p38MAPK,JNK,and Akt phosphorylation.In LPS-treated RAW264.7 macrophages,liriodendrin reduced NO production,pro-inflammatory cytokines,and NLRP3 formation,suggesting its potential as an agent for ARDS and relative inflammation.
文摘Thyroid cancer is a common endocrine malignancy with a rising incidence.Pa-tients often suffer from mental pain due to concerns about recurrence,treatment-related side-effect,and body image changes.Demographic factors like age,gender,physiological factors such as somatic symptoms and disease stage,co-gnitive-regulatory factors including negative and positive thinking,and social factors like work,economy,education level,and social support all influence their mental state.Existing interventions,including nursing,psychological,and tra-ditional Chinese medicine-based methods,have some benefits but face limitations like short-term effectiveness and lack of standardization.Future research should focus on creating better-defined,long-term,and widely applicable intervention programs and explore positive psychology-based approaches to improve patients'mental well-being and quality of life.
文摘Objectives:The study aimed to examine the severity of moral distress and intention to leave among ICU nurses in the United Arab Emirates(UAE),and explore the influencing factors of intention to leave.Methods:The study utilized a cross-sectional research design.A convenience non-probability sample of 341 nurses from various private and government hospitals across different emirates in the UAE participated in June 2022.Data were collected using a self-administered questionnaire comprising demographic information,the Moral Distress Scale–Revised.Multivariable logistic regression was used to identify factors associated with intention to leave.Results:The study found that a large majority(71.9%)of ICU nurses experienced severe moral distress,and more than 35%had intention to leave.Futile end-of-life interventions emerged as the most distress-provoking aspect of practice[16.0(0,16.0)].Multivariable analysis revealed nurses experiencing severe moral distress had 3.73 times the odds of intending to leave their job compared with those experiencing mild distress(95%CI:1.81,7.69;P<0.001)and being aged 31–40 years(OR=2.02;95%CI:1.23,3.33;P=0.005)was independently associated with a higher intention to leave.Conclusions:Severe moral distress was prevalent among ICU nurses in the UAE and strongly associated with intention to leave,and also those aged 31–40 years.Promoting ethical support,shared decision-making,and nurse empowerment is vital to improving retention and care quality.
文摘BACKGROUND Diabetes distress(DD),an emotional problem arising from the challenges of living with diabetes and the relentless burden of daily self-management,is common among patients with type 2 diabetes(T2D).South Asia has a high T2D burden,and many studies have reported varying prevalence rates of DD in this area.AIM To estimate the pooled prevalence of DD among patients with T2D in South Asia,as it is crucial for developing effective therapeutic strategies.METHODS This systematic review and meta-analysis included cross-sectional studies conducted in South Asian countries involving adults with T2D and reported the prevalence of DD.The studies were identified by searching multiple electronic databases and registries from the inception of each database to January 30,2025,using prespecified search terms.Four authors screened and extracted data independently.Meta-analyses were conducted using RStudio software with a random-effects model.The primary outcome was the pooled prevalence of DD.RESULTS Thirty-seven cross-sectional studies(28 from India,five from Bangladesh,and two each from Pakistan and Sri Lanka)with mostly high methodological quality involving 11500 subjects were included.The pooled prevalence of DD was 44%(95%confidence interval:35-53,I2=97.4%).The prevalence of DD was highest in Pakistan(85%),followed by India and Bangladesh(42%each),and Sri Lanka(25%).Emotional burden was the most prevalent form of DD(60%),followed by treatment regimen-related distress(51%),interpersonal distress(31%),and physician-related distress(17%).Meta-regression analysis revealed no significant associations between the prevalence of DD and publication year,sample size,proportion of females,age,duration of diabetes,insulin usage,glycated hemoglobin levels,or diabetic complications.CONCLUSION South Asians with T2D seem to experience a relatively high burden of DD,and the emotional burden is the most common form of DD in this area.Larger studies utilizing unique tools and involving a broader participant base from the region would provide better epidemiological data for effectively planning high-quality diabetes care in South Asian countries.
基金supported in part by the National Natural Science Foundation of China(52378431,52408454)Fundamental Research Funds for the Central Universities,Chang’an University(300102210302,300102210118)+1 种基金111 Project of Sustainable Transportation for Urban Agglomeration in Western China(B20035)the 111 Project of Low Carbon Smart Road Infrastructure Construction and Maintenance Discipline Innovation and Talent Introduction Base of Shaanxi Province.
文摘Pavement distress detection plays a pivotal role in ensuring roadway safety,serviceability,and cost-effective infrastructure management.With rapid advancements in intelligent transportation systems,computer vision,and sensing technologies,non-contact detection approaches based on images and point clouds have become increasingly prominent due to their efficiency,objectivity,and scalability.This review systematically examines both image-based and point cloud-based methodologies,structured along the complete detection pipeline encompassing data acquisition,preprocessing,distress extraction,and geometric quantification.Image-based techniques rely on visual cues,such as texture,color,and edge continuity,to identify surface-level anomalies efficiently,benefiting from mature deep learning frameworks for classification,object detection,and pixel-level segmentation.In contrast,point cloud-based methods capture rich three-dimensional geometric and structural information,enabling detailed modeling of crack depth,rutting deformation,and surface irregularities.Although each modality can independently achieve satisfactory performance,their complementary strengths have driven a growing trend toward hybrid frameworks,combining image-based rapid screening with point cloud-based precision modeling,to enhance detection accuracy,robustness,and adaptability across varying conditions.Furthermore,this paper highlights persistent challenges,including multimodal data fusion,high equipment and labeling costs,computational complexity,and the need for standardized benchmarks.By synthesizing current progress and identifying key technical bottlenecks,this review provides a comprehensive foundation and forward-looking perspective for developing intelligent,efficient,and scalable pavement distress detection systems.
基金Supported by National Natural Science Foundation of China,No.82374400Heilongjiang Province“Double First-Class”New Round of Construction Disciplines Collaborative Innovation Achievements Construction Project,No.LJGXCG2022-097.
文摘Acute respiratory distress syndrome(ARDS)is a severe and life-threatening manifestation of acute lung injury,characterized by widespread pulmonary inflammation and edema,ultimately resulting in acute respiratory failure.Despite advancements in mechanical ventilation and lung-protective strategies,targeted therapies aimed at modulating dysregulated inflammation and promoting tissue repair remain elusive.Extracellular vesicles(EVs),critical mediators of intercellular communication,have emerged as a promising research focus due to their dual regulatory roles in ARDS pathogenesis.Pro-inflammatory EVs,derived from pathogens or injury-stressed cells,exacerbate alveolar macrophage activation and increase endothelial permeability,thereby aggravating pulmonary damage.In contrast,anti-inflammatory EVs originating from mesenchymal stem cells facilitate alveolar barrier restoration and tissue repair by delivering reparative molecular cargo.This review systematically evaluates the dualistic functions of EVs in ARDS from three key perspectives:Molecular mechanisms,clinical translation,and technical challenges.We further discuss the complexities associated with EV heterogeneity,pathogen interactions,and standardization in EV production.Additionally,we propose future directions that integrate engineered EV modifications and multi-omics approaches to address current therapeutic limitations and enhance ARDS management.
基金China Postdoctoral Science Foundation(No.2023M740237,2024M750254)Postdoctoral Fellowship Program of CPSF(No.GZB20230934)+1 种基金National Natural Science Foundation of China(No.71801113,72401029,72431003)China Scholarship Council(No.202006060162).
文摘Financial distress prediction(FDP)is a critical area of study for researchers,industry stakeholders,and regulatory authorities.However,FDP tasks present several challenges,including high-dimensional datasets,class imbalances,and the complexity of parameter optimization.These issues often hinder the predictive model’s ability to accurately identify companies at high risk of financial distress.To mitigate these challenges,we introduce FinMHSPE—a novel multi-heterogeneous self-paced ensemble(MHSPE)FDP learning framework.The proposed model uses pairwise comparisons of data from multiple time frames combined with the maximum relevance and minimum redundancy method to select an optimal subset of features,effectively resolving the high dimensionality issue.Furthermore,the proposed framework incorporates the MHSPE model to iteratively identify the most informative majority class data samples,effectively addressing the class imbalance issue.To optimize the model’s parameters,we leverage the particle swarm optimization algorithm.The robustness of our proposed model is validated through extensive experiments performed on a financial dataset of Chinese listed companies.The empirical results demonstrate that the proposed model outperforms existing competing models in the field of FDP.Specifically,our FinMHSPE framework achieves the highest performance,achieving an area under the curve(AUC)value of 0.9574,considerably surpassing all existing methods.A comparative analysis of AUC values further reveals that FinMHSPE outperforms state-of-the-art approaches that rely on financial features as inputs.Furthermore,our investigation identifies several valuable features for enhancing FDP model performance,notably those associated with a company’s information and growth potential.
文摘Objective:To explore the correlation between disease uncertainty and psychological distress in hospitalized patients with primary liver cancer,providing a basis for clinical nursing interventions.Methods:A convenient sampling method was used to select 82 patients with primary liver cancer from a tertiary first-class hospital in Guangzhou from September 2023 to March 2024 as the research subjects.General information questionnaires,the Mishel Uncertainty in Illness Scale-Adult Version(MUIS-A),and the Kessler Psychological Distress Scale(K10)were used for investigation.Pearson correlation analysis and linear regression analysis were performed to explore the relationship between the two.Results:The total score of disease uncertainty in hospitalized patients with primary liver cancer was(99.20±8.79),and the total score of psychological distress was(22.87±9.46),both at a medium level.There was a positive correlation between disease uncertainty and psychological distress(r=0.360,P<0.01),and the ambiguity dimension had the strongest correlation with psychological distress(r=0.399,P<0.01).Regression analysis showed that the ambiguity dimension had a significant predictive effect on psychological distress(β=0.399,P<0.01).Conclusion:There is a close correlation between disease uncertainty and psychological distress in patients with primary liver cancer.In clinical nursing,it is necessary to pay special attention to patients’ambiguity regarding disease symptoms and prognosis.Targeted health education should be carried out to reduce their uncertainty,thereby improving their psychological state.
基金supported by the National Natural Science Foundation of China(82102311)Peking Union Medical Foundation-Rui E(Rui Yi)Emergency Medicine Research Special Fund(22222012001)+2 种基金Xuzhou Municipal Health Commission Medical Science and Technology Innovation Project(XWKYHT20240080)Xuzhou Medical University Affiliated Hospital Science and Technology Development Fund(XYFY202402)Translational Medicine Foundation from Jiangsu Society of Research Hospital(SYHKJ-XF-2025-22).
文摘Autophagy plays a pivotal role in the development and resolution of sepsis-induced acute respiratory distress syndrome(S-ARDS),a critical condition characterized by severe inflammation,oxidative stress,apoptosis,and immune dysfunction.Traditional Chinese medicine(TCM)has emerged as a promising complementary therapy that modulates autophagy-related pathways.This review summarizes recent advances in understanding how TCM regulates autophagy to alleviate S-ARDS pathology.We highlight the mechanisms by which TCM influences autophagy to modulate inflammation,redox balance,programmed cell death,and immune responses.The integration of historical wisdom and modern molecular insights offers new therapeutic directions for S-ARDS treatment.
基金Supported by Wuxi Institute of Translational Medicine Project Program,No.LCYJ202336the Scientific and Technological Achievements Promotion Project of Wuxi Municipal Health Commission Project Program,No.T202336+1 种基金Hospital Management Innovation Research Project of Jiangsu Hospital Association,No.JSYGY-3-2024-601Jiangsu Provincial Traditional Chinese Medicine Science and Technology Development Plan Project,No.MS2024063。
文摘BACKGROUND Grief counseling has become relatively established and is widely used among the families of cancer patients,effectively alleviating their psychological pain.However,in China,due to the influence of Confucianism and other traditional cultures,people generally adhere to the belief of“reincarnation to avoid death”,focusing more on themes of life,such as eugenics and longevity,and paying less attention to matters related to death,including death education and grief counseling.Currently,grief counseling in China is still in an exploratory stage,and there is relatively little research on the psychological status of family members of patients with terminal tumors.AIM To investigate the psychological effects of grief counseling on family members of terminal cancer patients.METHODS This study was designed as a randomized controlled trial that utilized convenience sampling to select family members of terminal tumor patients who were admitted to the hospice ward of the Affiliated Hospital of Jiangnan University from January to June 2025 as research subjects.All participants received conventional symptomatic supportive treatment and palliative care.Additionally,the intervention group benefited from extra grief counseling.RESULTS The Distress Thermometer(DT)score of the control group slightly decreased compared to before the intervention,but the difference was not statistically significant(P>0.05).In contrast,the DT score of the intervention group decreased significantly compared to before the intervention,with a statistically significant difference(P<0.05).After the intervention,the DT score of the intervention group was lower than that of the control group,and the difference was also statistically significant(P<0.05).After the intervention,the intervention group performed better DT level than the control group,with a statistically significant difference(P<0.05),the intervention group outperformed the control group in terms of depression and anxiety,and the difference was statistically significant(P<0.05).CONCLUSION Grief counseling can help alleviate the psychological pain and negative emotions experienced by family members of patients with terminal malignant tumors.
文摘BACKGROUND Mesenchymal stem cells(MSCs),as a living bio-drug,are being considered as a potential treatment for coronavirus disease 2019(COVID-19)-induced acute res-piratory distress syndrome(ARDS)due to their immunomodulatory and repa-rative properties.AIM To synthesize the existing evidence on MSCs and their derivative exosomes for treating COVID-19-induced ARDS,with a focus on the key outcomes of safety and efficacy.METHODS Four databases were systematically searched for randomized controlled trials assessing MSCs and their derived exosomes for COVID-19-induced ARDS trea-tment.Their safety and efficacy were evaluated based on the duration of mecha-nical ventilation,hospital and intensive care unit stay,6-minute walk distance,mortality rates,and adverse events.Weighted mean differences and odds ratios with 95%confidence intervals(CIs)were calculated to estimate treatment out-comes:A network meta-analysis(NMA)evaluated mortality,adverse events,and the number of ventilation-free days.RESULTS Sixteen randomized controlled trials involving 1027 ARDS patients were in-cluded,with 574 receiving MSCs or MSC-derived exosomes.MSC-based therapy did not significantly improve mechanical ventilation duration,ventilation-free days,hospital or intensive care unit stay,or 6-minute walk distance.Sensitivity analysis revealed a significant reduction in mechanical ventilation duration when excluding an outlier(weighted mean difference:-4.84 days;95%CI:-8.21 to-1.47;I2=20%).In contrast,no significant differences were observed in the other outcomes.Mortality and adverse events were comparable between the groups(odds ratio for mortality:0.77;95%CI:0.56-1.06).An NMA of ventilation-free days,mortality,and adverse events revealed no significant difference among MSCs,exosomes,and controls.Exosomes ranked highest in terms of probability of benefit,although without statistical significance.CONCLUSION MSC and exosome-based therapies were found to be safe and associated with a reduced duration of mechanical ventilation in patients with ARDS.NMA showed that exosome-based therapy matched the benefits of its parent cells,but with practical and logistical advantages.
文摘BACKGROUND Chronic kidney disease(CKD)is an incapacitating illness associated with distressing symptoms(DS)that have negative impact on patients’health-related quality of life(HRQOL).AIM To assess the severity of DS and their relationships with HRQOL among patients with CKD in Jordan.METHODS A descriptive cross-sectional design was used.A convenience sampling approach was used to recruit the participants.Patients with CKD(n=140)who visited the outpatient clinics in four hospitals in Amman between November 2021 and December 2021 were included.RESULTS The Edmonton Symptom Assessment System was used to measure the severity of the DS while the Short Form-36 tool was used to measure the HRQOL.Participants’mean age was 50.9(SD=15.14).Most of them were males(n=92,65.7%),married(n=95,67.9%),and unemployed(n=93,66.4%).The highest DS were tiredness(mean=4.68,SD=2.98)and worse well-being(mean=3.69,SD=2.43).The highest HRQOL mean score was for the bodily pain scale with a mean score of 68.50 out of 100(SD=32.02)followed by the emotional well-being scale with mean score of 67.60(SD=18.57).CONCLUSION Patients with CKD had suboptimal HRQOL,physically and mentally.They suffer from multiple DS that have a strong association with diminished HRQOL such as tiredness and depression.Therefore,healthcare providers should be equipped with the essential knowledge and skills to promote individualized strategies that focusing on symptom management.
文摘Objective:To analyze the value of bedside cranial ultrasonography in the early diagnosis of neonatal brain tissue injury in intrauterine distress.Methods:128 neonates with suspected intrauterine distress admitted to the Yichang Central People’s Hospital from January 2023 to December 2024 were selected as study subjects based on the inclusion and exclusion criteria,and all subjects underwent bedside craniocerebral ultrasonography and MRI,and the results of MRI were used as the gold standard to divide the infants into the brain-injury group(n=31)and the no-brain-injury The children were divided into brain injury group(n=31)and no brain injury group(n=97),and the value of bedside cranial ultrasonography for early diagnosis of brain tissue injury in neonates with intrauterine distress was analyzed.Results:(1)Among the 128 cases of intrauterine distress neonates,31 cases were examined for abnormal signs,including 22 cases(70.97%)examined by bedside craniocerebral ultrasonography and 28 cases(90.32%)examined by MRI.(2)Bedside cranial ultrasound detected hypoxic-ischemic encephalopathy in 6 cases,accounting for 4.69%,ventricular widening in 2 cases,accounting for 1.56%,intracranial hemorrhage in 8 cases,accounting for 6.25%,periventricular softening of white matter in 5 cases,accounting for 3.91%,and cerebral edema in 1 case,accounting for 0.78%,while MRI detected hypoxic-ischemic encephalopathy in 9 cases,accounting for 7.03%.3 cases of ventricular widening,accounting for 2.34%,4 cases of intracranial hemorrhage,accounting for 3.13%,9 cases of periventricular-intraventricular white matter softening,accounting for 7.03%,and 3 cases of cerebral edema,accounting for 2.34%were examined.Among them,the detection rate of periventricular-intraventricular hemorrhage by bedside cranial ultrasound was significantly higher than that of MRI(P<0.05).Conclusion:The diagnostic value of bedside cranial ultrasound in periventricular-intraventricular hemorrhage is high,but the diagnostic value is not as good as that of MRI in other brain tissue injuries,and clinically appropriate examination protocols can be selected according to the specific types of craniocerebral injuries.
