This paper thoroughly explores the multifaceted factors influencing the efficacy of Chinese medicinals and categorizes them into three main groups:medicinal related factors,patient related factors,and practitioner rel...This paper thoroughly explores the multifaceted factors influencing the efficacy of Chinese medicinals and categorizes them into three main groups:medicinal related factors,patient related factors,and practitioner related factors.Regarding medicinal related factors,the place of origin,growing environment,harvesting time,storage conditions,quality control,dosage form selection,compatibility of medicinals,precise dosing,decoction methods,and administration routes all significantly impact efficacy.The place of origin determines the authenticity of medicinals,the growing environment affects their composition,harvesting time influences potency,improper storage leads to deterioration,quality control forms the foundation of efficacy,dosage forms and compatibility of medicinals affect absorption,dosing and decoction methods require precision,and administration routes should be tailored to individuals.Patient related factors include psychological state,individual differences,background,and disease condition.Psychological state affects treatment compliance,individual differences determine medicine responses,background influences patients’understanding of Chinese medicinals,and disease condition directly reflects efficacy.Practitioner related factors encompass theoretical knowledge,clinical experience,inherited practices,psychological state,and professional ethics.Theoretical knowledge guides medication use,clinical experience enhances efficacy,inherited practices influence prescribing styles,psychological state affects doctor–patient communication,and professional ethics ensure medical quality.These interrelated factors collectively influence the efficacy of Chinese medicinals,emphasizing the need for comprehensive consideration in clinical applications to achieve optimal therapeutic outcomes.展开更多
Understanding crash contributing factors is essential in safety management and improvement. These factors drive investment decisions, policies, regulations, and other safety-related initiatives. This paper analyzes fa...Understanding crash contributing factors is essential in safety management and improvement. These factors drive investment decisions, policies, regulations, and other safety-related initiatives. This paper analyzes factors that contribute to crash occurrence based on two national datasets in the United States (CISS and NASS-CDS) for the years 2017-2022 and 2010-2015, respectively. Three taxonomies were applied to enhance understanding of the various crash contributing factors. These taxonomies were developed based on previous research and practice and involved different groupings of human factors, vehicle factors, and roadway and environmental factors. Statistics for grouping the different types of factors and statistics for specific factors are provided. The results indicate that human factors are present in over 95% of crashes, roadway and environmental factors are present in over 45% of crashes, and vehicle factors are present in less than 2% of crashes. Regarding factors related to human error and vehicle maintenance, speeding is involved in over 25% of crashes, distraction is involved in over 20% of crashes, alcohol and drugs are involved in over 9% of crashes, and vehicle maintenance is involved in approximately 0.45% of crashes. Approximately 4.4% of crashes involve a driver who “looked but did not see.” Weather is involved in over 13% of crashes. Conclusions: The findings indicate that, consistent with previous research, human factors or human error are present in around 95% of crashes. Infrastructure and environmental factors contribute to about 45% of crashes. Vehicle factors contribute to only 1.67% - 1.71% of crashes. The results from this study could potentially be used to inform future safety management and improvement activities, including policy-making, regulation development, safe systems and systemic safety approaches to safety management, and other engineering, education, emergency response, enforcement, evaluation, and encouragement activities. The findings could also be used in the development of future Driver Assistance Technologies (DAT) systems and in enhancing existing technologies.展开更多
Background:To evaluate sex‐related differences in the risk factors associated with nonhealing or recurrence of hyper-thyroidism(NHRH)in patients with Graves'disease(GD)treated with radioactive iodine.Methods:In t...Background:To evaluate sex‐related differences in the risk factors associated with nonhealing or recurrence of hyper-thyroidism(NHRH)in patients with Graves'disease(GD)treated with radioactive iodine.Methods:In total,285 patients were enrolled.Data on radioactive iodine(RAI)dosage,ultrasound indexes of the thyroid,and other clinical factors were collected.Patients were divided into NHRH and non‐NHRH(hypothyroidism or euthyroidism)groups based on treatment outcomes.Univariate and multivariate weighted logistic regression analyses were used to identify factors associated with NHRH.Sex‐specific analyses of these risk factors were also conducted.Results:There were no significant differences between the two groups in terms of sex,thyroid shear wave elastography velocity values,or pretreatment serum free thyroxine(FT4)levels.Thyroid volume and age were independently associated with NHRH,with the odds of NHRH gradually decreasing as age increased.In subgroup analyses,both age and thyroid volume were independent risk factors for NHRH in female patients(p<0.05),while in male patients,only FT4 was independently associated with NHRH(p<0.05).Conclusions:In patients of different sexes,the influence of thyroid volume,age,and FT4 on treatment outcomes exhibits distinct patterns.展开更多
Background:The accurate identification of cardiac abnormalities is essential for proper diagnosis and effective treatment of cardiovascular diseases.Method:This work introduces an advanced methodology for detecting ca...Background:The accurate identification of cardiac abnormalities is essential for proper diagnosis and effective treatment of cardiovascular diseases.Method:This work introduces an advanced methodology for detecting cardiac abnormalities and estimating electrocardiographic age(ECG Age)using sophisticated signal processing and deep learning techniques.This study looks at six main heart conditions found in 12-lead electrocardiogram(ECG)data.It addresses important issues like class imbalances,missing lead scenarios,and model generalizations.A modified residual neural network(ResNet)architecture was developed to enhance the detection of cardiac abnormalities.Results:The proposed ResNet demonst rated superior performance when compared with two linear models and an alternative ResNet architectures,achieving an overall classification accuracy of 91.25%and an F1 score of 93.9%,surpassing baseline models.A comprehensive lead loss analysis was conducted,evaluating model performance across 4096 combinations of missing leads.The results revealed that pulse rate-based factors remained robust with up to 75%lead loss,while block-based factors experienced significant performance declines beyond the loss of four leads.Conclusion:This analysis highlighted the importance of addressing lead loss impacts to maintain a robust model.To optimize performance,targeted training approaches were developed for different conditions.Based on these insights,a grouping strategy was implemented to train specialized models for pulse rate-based and block-based conditions.This approach resulted in notable improvements,achieving an overall classification accuracy of 95.12%and an F1 score of 95.79%.展开更多
Nerve trauma commonly results in chronic neuropathic pain. This is by triggering the release of proinflammatory mediators from local and invading cells that induce inflammation and nociceptive neuron hyperexcitability...Nerve trauma commonly results in chronic neuropathic pain. This is by triggering the release of proinflammatory mediators from local and invading cells that induce inflammation and nociceptive neuron hyperexcitability. Even without apparent inflammation, injury sites are associated with increased inflammatory markers. This review focuses on how it might be possible to reduce neuropathic pain by reducing inflammation. Physiologically, pain is resolved by a combination of the out-migration of pro-inflammatory cells from the injury site, the down-regulation of the genes underlying the inflammation, up-regulating genes for anti-inflammatory mediators, and reducing nociceptive neuron hyperexcitability. While various techniques reduce chronic neuropathic pain, the best are effective on < 50% of patients, no technique reliably or permanently eliminates neuropathic pain. This is because most techniques are predominantly aimed at reducing pain, not inflammation. In addition, while single factors reduce pain, increasing evidence indicates significant and longer-lasting pain relief requires multiple factors acting simultaneously. Therefore, it is not surprising that extensive data indicate that the application of platelet-rich plasma provides more significant and longer-lasting pain suppression than other techniques, although its analgesia is neither complete nor permanent. However, several case reports indicate that platelet-rich plasma can induce permanent neuropathic pain elimination when the platelet concentration is significantly increased and is applied to longer nerve lengths. This review examines the primary triggers of the development and maintenance of neuropathic pain and techniques that reduce chronic neuropathic pain. The application of plateletrich plasma holds great promise for providing complete and permanent chronic neuropathic pain elimination.展开更多
As a major global public health issue,tuberculosis is closely related to multiple socio-ecological factors in its epidemiological patterns~([1]).China,as a high-burden country for tuberculosis,exhibits regional variat...As a major global public health issue,tuberculosis is closely related to multiple socio-ecological factors in its epidemiological patterns~([1]).China,as a high-burden country for tuberculosis,exhibits regional variations in the distribution of the tuberculosis epidemic.To enhance the efficiency of prevention and control,its strategies are undergoing a transition toward regionally differentiated approaches~([2]).展开更多
In this paper,we study the ρ-meson electromagnetic form factors(EMFFs)within the framework of the light-front quark model.The physical form factors G_(C,M,Q)(Q^(2))of the ρ-meson,as well as the charged square radius...In this paper,we study the ρ-meson electromagnetic form factors(EMFFs)within the framework of the light-front quark model.The physical form factors G_(C,M,Q)(Q^(2))of the ρ-meson,as well as the charged square radius<r^(2)>,the magnetic moment μ,and the quadrupole moment Q,are calculated,which describe the behaviors of EMFFs at zero momentum transfer.Using the type-Ⅱ replacement,we find that the zero-mode does contribute zero to the matrix element S_(00)^(+).It is found that the“M→M_(0)”replacement improves the angular condition remarkably,which permits different prescriptions of ρ-meson EMFFs to give the consistent results.The residual tiny violation of angular condition needs other explanations beyond the zero-mode contributions.Our results indicate that the relativistic effects or interaction internal structure are weaken in the zero-binding limit.This work is also applicable to other spin-1 particles.展开更多
Most research on carbon storage in forests has focused on qualitative studies of carbon storage and influ-encing factors rather than on quantifying the effect of the spatial distribution of carbon storage and of its i...Most research on carbon storage in forests has focused on qualitative studies of carbon storage and influ-encing factors rather than on quantifying the effect of the spatial distribution of carbon storage and of its influencing factors at different scales.Here we described the spatial dis-tribution of aboveground carbon storage(ACS)in a 20-ha plot in a subtropical evergreen broad-leaved forest to evalu-ate and quantify the relative effects of biotic factors(species diversity and structural diversity)and abiotic factors(soil and topographic factors)on ACS at different scales.Scale effects of the spatial distribution of ACS were significant,with higher variability at smaller scales,but less at larger scales.The distribution was also spatially heterogeneous,with more carbon storage on north-and east-facing slopes than on south-and west-facing slopes.At a smaller scale,species diversity and structural diversity each had a direct positive impact on ACS,but soil factors had no significant direct impact.At increasing scales,topographic and soil fac-tors gradually had a greater direct influence,whereas the influence of species diversity gradually decreased.Structural diversity had the greatest impact,followed by topographic factors and soil factors,while species diversity had a rela-tively smaller impact.These findings suggest studies on ACS in subtropical evergreen broadleaf forests in southern China should consider scale effects,specifically on the heterogene-ity of ACS distribution at small scales.Studies and conser-vation efforts need to focus on smaller habitat types with particular emphasis on habitat factors such as aspect and soil conditions,which have significant influences on community species diversity,structural diversity,and ACS distribution.展开更多
BACKGROUND Antenatal depression is a disabling mental disorder among pregnant women and may cause adverse outcomes for both the mother and the offspring.Early identification and intervention of antenatal depression ca...BACKGROUND Antenatal depression is a disabling mental disorder among pregnant women and may cause adverse outcomes for both the mother and the offspring.Early identification and intervention of antenatal depression can help to prevent adverse outcomes.However,there have been few population-based studies focusing on the association of social and obstetric risk factors with antenatal depression in China.AIM To assess the sociodemographic and obstetric factors of antenatal depression and compare the network structure of depressive symptoms across different risk levels based on a large Chinese population.METHODS The cross-sectional survey was conducted in Shenzhen,China from 2020 to 2024.Antenatal depression was assessed using the Chinese version of the Edinburgh Postnatal Depression Scale(EPDS),with a score of≥13 indicating the presence of probable antenatal depression.Theχ2 test and binary logistic regression were used to identify the factors associated with antenatal depression.Network analyses were conducted to investigate the structure of depressive symptoms across groups with different risk levels.RESULTS Among the 44220 pregnant women,the prevalence of probable antenatal depression was 4.4%.An age≤24 years,a lower level of education(≤12 years),low or moderate economic status,having a history of mental disorders,being in the first trimester,being a primipara,unplanned pregnancy,and pregnancy without pre-pregnancy screening were found to be associated with antenatal depression(all P<0.05).Depressive symptom networks across groups with different risk levels revealed robust interconnections between symptoms.EPDS8("sad or miserable")and EPDS4("anxious or worried")showed the highest nodal strength across groups with different risk levels.CONCLUSION This study suggested that the prevalence of antenatal depression was 4.4%.Several social and obstetric factors were identified as risk factors for antenatal depression.EPDS8("sad or miserable")and EPDS4("anxious or worried")are pivotal targets for clinical intervention to alleviate the burden of antenatal depression.Early identification of highrisk groups is crucial for the development and implementation of intervention strategies to improve the overall quality of life for pregnant women.展开更多
Depression is a severe mood disorder characterized by complex suicide mechanisms that involve a multitude of psychosocial and biological fac-tors.This paper presents a comprehensive analysis of the psychosocial factor...Depression is a severe mood disorder characterized by complex suicide mechanisms that involve a multitude of psychosocial and biological fac-tors.This paper presents a comprehensive analysis of the psychosocial factors influencing suicidal behavior in depression,including social support,life events,depressive symptoms,and personality traits,as well as biological factors such as brain-derived neurotrophic factor(BDNF),erotonin(5-TH)system dysfunction,and hypothalam-ic-pituitary-adrenal(HPA)axis abnormalities.Collectively,these factors significantly influence an individual’s risk of suicide,with biological factors serving as potential biomarkers for suicidal actions and psychosocial factors underscoring the impact of environmental and individual experiences.Understanding the interaction of these factors is crucial for comprehending and preventing suicidal behavior in depression.Despite considerable progress,current studies have limitations,particularly regarding the unclear interaction mechanisms between psychosocial and biological factors and a predominant focus on adult populations,with insufficient comprehensive studies on adolescents.展开更多
Introduction: Multiple endocrine and metabolic abnormalities, particularly overweight and obesity, have emerged as significant global public health concerns. This paper examines the impact of these conditions on healt...Introduction: Multiple endocrine and metabolic abnormalities, particularly overweight and obesity, have emerged as significant global public health concerns. This paper examines the impact of these conditions on health outcomes and underscores the necessity for comprehensive strategies to address them. Background: Overweight and obesity have been observed in patients with human immunodeficiency virus (HIV) both before and after the initiation of antiretroviral therapy. This study investigates the risk factors associated with overweight and obesity in HIV-infected patients. Methods: A total of 492 HIV-infected patients, both treatment-naïve and those undergoing treatment, were recruited from Yaoundé Central Hospital in Cameroon. Demographic, anthropometric, and biochemical data were collected from each patient. Blood pressure and abdominal fat measurements were also taken. Metabolic syndrome was defined according to IDF criteria. Patients were categorized into two weight status groups: underweight/normal weight and overweight/obese. Results: The prevalence of overweight and obesity was found to be 27.5% and 8.5%, respectively, with only 6.1% of patients being underweight. Abdominal obesity, systolic/diastolic blood pressure, metabolic syndrome, and CD4 cell counts were associated with risk factors in overweight and obese patients. These parameters should be considered when investigating metabolic disorders in HIV-infected patients, as in the general population. Conclusion: Our study indicates a high risk of developing metabolic syndrome among overweight/obese individuals, who were 5.7 times more likely to have metabolic syndrome compared to those of normal weight/underweight. These findings support the hypothesis that overweight and obesity are also prevalent in HIV-infected patients and they are risk factors that have to be taken into consideration to better manage this issue. These results may provide essential information on the fact that being underweight is not the only issue to take into consideration in these patients but that overweight/obesity is now present. Prevention and management strategies should consider both aspects.展开更多
The image of China in The Painted Veil by Maugham is complicated and diversified.On the one hand,it predicts numerous representative sceneries of the Chinese village,unveiling the exotic natural sceneries of China.Mor...The image of China in The Painted Veil by Maugham is complicated and diversified.On the one hand,it predicts numerous representative sceneries of the Chinese village,unveiling the exotic natural sceneries of China.Moreover,the spirit of Taoism is stated in the novel,unveiling the mysterious culture of Chinese’concern about the harmony of man and nature,which displays Maugham’s admiration for Chinese exotic flavors.On the other hand,China is depicted as poor and undeveloped,a country stricken by epidemic diseases and opium smokers.This article aims to analyze the factors affecting Maugham’s images of China from the subjective and objective perspectives.Chapter two profoundly explores the significant influence of Maugham’s life experience,religious belief and personal values on his individual images of China.Chapter three expounds the effective factors of social thoughts and economy.From the exploration,it is apparent that the formation of the image of China in The Painted Veil is firstly influenced by the life experience,individual values and religious belief of Maugham.Literary writing is actually a miniature and indirect representation of the author’s life experience.展开更多
BACKGROUND At present,the influencing factors of social function in patients with residual depressive symptoms are still unclear.Residual depressive symptoms are highly harmful,leading to low mood in patients,affectin...BACKGROUND At present,the influencing factors of social function in patients with residual depressive symptoms are still unclear.Residual depressive symptoms are highly harmful,leading to low mood in patients,affecting work and interpersonal communication,increasing the risk of recurrence,and adding to the burden on families.Studying the influencing factors of their social function is of great significance.AIM To explore the social function score and its influencing factors in patients with residual depressive symptoms.METHODS This observational study surveyed patients with residual depressive symptoms(case group)and healthy patients undergoing physical examinations(control group).Participants were admitted between January 2022 and December 2023.Social functioning was assessed using the Sheehan Disability Scale(SDS),and scores were compared between groups.Factors influencing SDS scores in patients with residual depressive symptoms were analyzed by applying multiple linear regression while using the receiver operating characteristic curve,and these RESULTS The SDS scores of the 158 patients with depressive symptoms were 11.48±3.26.Compared with the control group,the SDS scores and all items in the case group were higher.SDS scores were higher in patients with relapse,discon-tinuous medication,drug therapy alone,severe somatic symptoms,obvious residual symptoms,and anxiety scores≥8.Disease history,medication compliance,therapy method,and residual symptoms correlated positively with SDS scores(r=0.354,0.414,0.602,and 0.456,respectively).Independent influencing factors included disease history,medication compliance,therapy method,somatic symptoms,residual symptoms,and anxiety scores(P<0.05).The areas under the curve for predicting social functional impairment using these factors were 0.713,0.559,0.684,0.729,0.668,and 0.628,respectively,with sensitivities of 79.2%,61.8%,76.8%,81.7%,63.6%,and 65.5%and specificities of 83.3%,87.5%,82.6%,83.3%,86.7%,and 92.1%,respectively.CONCLUSION The social function scores of patients with residual symptoms of depression are high.They are affected by disease history,medication compliance,therapy method,degree of somatic symptoms,residual symptoms,and anxiety.展开更多
BACKGROUND: This study aimed to explore the risk factors associated with intensive care unitacquired weakness(ICU-AW) in critically ill patients at risk of malnutrition and to evaluate the efficacy of early enteral nu...BACKGROUND: This study aimed to explore the risk factors associated with intensive care unitacquired weakness(ICU-AW) in critically ill patients at risk of malnutrition and to evaluate the efficacy of early enteral nutrition(EEN) and the role of biomarkers in managing ICU-AW.METHODS: This retrospective, observational cohort study included 180 patients at risk of malnutrition admitted to the emergency intensive care unit of the First Affiliated Hospital of Xiamen University Hospital from January 2022 to December 2023. Patients were divided into ICU-AW group and non-ICU-AW group according to whether they developed ICU-AW, or categorized into EEN and parenteral nutrition(PN) groups according to nutritional support. ICU-AW was diagnosed using the Medical Research Council score. The primary outcome was the occurrence of ICU-AW.RESULTS: The significant factors associated with ICU-AW included age, sex, type of nutritional therapy, mechanical ventilation(MV), body mass index(BMI), blood urea nitrogen(BUN), and creatinine(Cr) levels(P<0.05). The PN group developed ICU-AW earlier than did the EEN group, with a significant difference observed(log-rank P<0.001). Among biomarkers for ICU-AW, the mean prealbumin(PAB)/C-reactive protein(CRP) ratio had the highest diagnostic accuracy(area under the curve [AUC] 0.928, 95% confidence interval [95% CI] 0.892–0.946), surpassing the mean Cr/BUN ratio(AUC 0.740, 95% CI 0.663–0.819) and mean transferrin levels(AUC 0.653, 95% CI 0.574–0.733).CONCLUSION: Independent risk factors for ICU-AW include female sex, advanced age, PN, MV, lower BMI, and elevated BUN and Cr levels. EEN may potentially delay ICU-AW onset, and the PAB/CRP ratio may be an effective diagnostic marker for this condition.展开更多
BACKGROUND Lung cancer(LC)is one of the most prevalent cancers globally,with a high incidence among the elderly population.Elderly patients,particularly those with diabetes mellitus,are at an increased risk of postope...BACKGROUND Lung cancer(LC)is one of the most prevalent cancers globally,with a high incidence among the elderly population.Elderly patients,particularly those with diabetes mellitus,are at an increased risk of postoperative complications,in-cluding pulmonary infections,due to weakened immune function and metabolic abnormalities.Postoperative pulmonary infection(PPI)is a predominant com-plication after thoracoscopic radical resection of LC,significantly affecting patient outcomes and increasing healthcare burdens.Determining risk factors for PPI in this vulnerable population is crucial for improving surgical outcomes and redu-cing infection rates.AIM To develop and validate a predictive model for PPI in elderly patients with dia-betes undergoing thoracoscopic radical resection for LC and to assess its reliability and validity.METHODS This retrospective study included 212 patients with LC who received treatment at our hospital from March 2015 to March 2022.General clinical information,sur-gical treatment details,and laboratory test results were collected and analyzed.Patients were grouped according to infection occurrence during the postoperative hospitalization period.Risk factors for PPIs were determined through logistic regression analysis,and a nomogram prediction model was established using R software to assess its predictive accuracy and performance.RESULTS Among the 212 patients[median age:72 years(interquartile range:60-82 years)],41 developed PPI(19.34%),with Gram-negative bacteria being the predominant pathogens(64.14%).Factors,such as age of≥70 years,presence of respiratory diseases,maximum tumor diameter of≥4 cm,stages II-III,receiving neoadjuvant chemotherapy of≥2 times preoperatively,surgery duration of≥3 hours,chest drainage tube placement duration of≥3.5 days,preoperative fasting blood glucose levels,hemoglobin A1c(HbA1c)levels,and multi-leaf resection,were markedly higher in the infection group than in the non-infection group.Conversely,forced expiratory volume in 1 second(FEV1)of≥80%and albumin(Alb)levels were lower in the infection group.Multivariate logistic regression analysis revealed that receiving neoadjuvant chemotherapy of≥2 times[odds ratio(OR)=2.987;P=0.036],maximum tumor diameter of≥4 cm(OR=3.959;P=0.013),multi-leaf resection(OR=3.18;P=0.036),preoperative FEV1 of≤80%(OR=3.305;P=0.029),and high HbA1c levels(OR=2.39;P=0.003)as key risk factors for PPI,whereas high Alb levels(OR=0.507;P<0.001)was protective.The nomogram model demonstrated excellent diagnostic ability(area under the curve=0.901,0.915),and calibration curves and decision curve analysis revealed good predictive performance and clinical applicability of the model.CONCLUSION The primary pathogens of PPI in elderly patients with diabetes and LC undergoing thoracoscopic radical resection are Gram-negative bacteria.The nomogram model,based on preoperative neoadjuvant chemotherapy cycles,maximum tumor diameter,range of resection,and preoperative FEV1,Alb,and HbA1c levels,shows high clinical value in predicting the risk of PPI in this patient population.展开更多
BACKGROUND Liver transplant(LT)recipients are susceptible to carbapenem-resistant Klebsiella pneumoniae(CRKP)infections.Comprehensive research addressing the incidence,timing,infection sites,resistance patterns,treatm...BACKGROUND Liver transplant(LT)recipients are susceptible to carbapenem-resistant Klebsiella pneumoniae(CRKP)infections.Comprehensive research addressing the incidence,timing,infection sites,resistance patterns,treatment options,and associated risk factors among LT recipients with CRKP is now lacking.AIM To assess the incidence,resistance,therapy,and risk factors of CRKP infections post-LT,and to evaluate the impact of them on prognosis.METHODS A retrospective study was conducted,including 430 consecutive patients who underwent LT between January 2015 and June 2023.This study aimed to investigate the risk factors for CRKP infections and their influence on outcomes using logistic regression analysis.RESULTS Among the 430 patients who underwent LT,20(4.7%)experienced at least one documented CRKP infection within 3 months post-transplantation.The median time from LT to the onset of CRKP infections was 6.5 days.The lungs and bloodstream were the most common sites of CRKP infections.CRKP isolates were relatively susceptible to ceftazidime/avibactam(93.7%),polymyxin B(90.6%),and tigecycline(75.0%)treatment.However,all isolates were resistant to piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,meropenem,and levofloxacin treatment.Recipients with CRKP infections had a mortality rate of 35%,the rate was 12.5%for those receiving ceftazidime/avibactam therapy.Multivariate analysis identified female sex[odds ratio(OR)=3.306;95%confidence interval(CI):1.239-8.822;P=0.017],intraoperative bleeding≥3000 mL(OR=3.269;95%CI:1.018-10.490;P=0.047),alanine aminotransferase on day 1 post-LT≥1500 U/L(OR=4.370;95%CI:1.686-11.326;P=0.002),and post-LT mechanical ventilation(OR=2.772;95%CI:1.077-7.135;P=0.035)as significant variables associated with CRKP.CRKP infections were related to an intensive care unit length(ICU)of stay≥7 days and 6-month all-cause mortality post-LT.CONCLUSION CRKP infections were frequent complications following LT,with poor associated outcomes.Risk factors for post-LT CRKP infections included female sex,significant intraoperative bleeding,elevated alanine aminotransferase levels,and the need for mechanical ventilation.CRKP infections negatively impacted survival and led to prolonged ICU stays.展开更多
BACKGROUND The development of hepatocellular carcinoma(HCC)is influenced by multiple factors.Interventional therapy offers an effective treatment option for patients with unresectable intermediate-to-advanced HCC.Inte...BACKGROUND The development of hepatocellular carcinoma(HCC)is influenced by multiple factors.Interventional therapy offers an effective treatment option for patients with unresectable intermediate-to-advanced HCC.Interventional therapy can induce electrocardiographic(ECG)abnormalities that may be associated with liver dysfunction,electrolyte disorders,and cardiac injury.AIM To explore the ECG alterations and determinants following interventional therapy in patients with HCC.METHODS Sixty patients undergoing interventional treatment for liver cancer were selected as study participants.According to the results of the dynamic ECG examination 1 day after surgery,the patients were divided into an abnormal group(n=21)and a nonabnormal group(n=39).With the help of dynamic ECG examination,the ECG parameters were compared and the baseline data of patients was recorded in the two groups.RESULTS The 24 hours QT interval variability,24 hours normal atrial polarization to ventricular polarization(R-R)interval(standard deviation),24 hours consecutive 5 minutes normal R-R interval,and 24 hours continuous 5 minutes normal R-R interval(standard deviation mean)were lower than patients in the nonabnormal group(P<0.05).The logistic analysis showed that age>60 years,liver function grade B,and postoperative body temperature 38°C were risk factors for abnormal dynamic electrocardiogram in patients with liver cancer intervention(P<0.05).CONCLUSION Interventional therapy for HCC can lead to ECG abnormalities,underscoring the clinical need for enhanced cardiac monitoring to mitigate myocardial complications.展开更多
Objectives:This systematic review and meta-analysis aimed to identify and synthesize the factors correlated with posttraumatic growth(PTG)in patients with colorectal cancer(CRC).Methods:PubMed,Web of Science,Embase,Ps...Objectives:This systematic review and meta-analysis aimed to identify and synthesize the factors correlated with posttraumatic growth(PTG)in patients with colorectal cancer(CRC).Methods:PubMed,Web of Science,Embase,PsycINFO,CINAHL,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang database,China Science and Technology Journal Database(VIP)and SinoMed were searched for studies that reported data on the correlated factors associated with PTG in patients with CRC from inception to September 3,2024.The methodological quality of the included studies was assessed via the Agency for Healthcare Research and Quality(AHRQ)methodology checklist and the Newcastle-Ottawa Scale(NOS).Pearson correlation coefficient(r)was utilized to indicate effect size.Meta-analysis was conducted in R Studio.Results:Thirty-one eligible studies encompassing 6,400 participants were included in this review.Correlated factors were identified to be significantly associated with PTG in patients with CRC including demographic factors:residential area(r=0.13),marital status(r=0.10),employment status(r=0.18),education level(r=0.19),income level(r=0.16);disease-related factors:time since surgery(r=0.17),stoma-related complications(r=0.14),health-promoting behavior(r=0.46),and sexual function(r=0.17);psychosocial factors:confrontation coping(r=0.68),avoidance coping(r=-0.65),deliberate rumination(r=0.56),social support(r=0.47),family function(r=0.50),resilience(r=0.53),selfefficacy(r=0.91),self-compassion(r=-0.32),psychosocial adjustment(r=0.39),gratitude(r=0.45),stigma(r=-0.65),self-perceived burden(r=-0.31),fear of cancer recurrence(r=-0.45);and quality of life(r=0.32).Conclusions:This meta-analysis identified 23 factors associated with PTG in CRC patients.Medical workers can combine those relevant factors from the perspective of positive psychology,further explore the occurrence and development mechanism of PTG,and establish targeted interventions to promote PTG.展开更多
The scientific assessment of ecosystem ser-vice value(ESV)plays a critical role in regional ecologi-cal protection and management,rational land use planning,and the establishment of ecological security barriers.The ec...The scientific assessment of ecosystem ser-vice value(ESV)plays a critical role in regional ecologi-cal protection and management,rational land use planning,and the establishment of ecological security barriers.The ecosystem service value of the Northeast Forest Belt from 2005 to 2020 was assessed,focusing on spatial–temporal changes and the driving forces behind these dynamics.Using multi-source data,the equivalent factor method,and geo-graphic detectors,we analyzed natural and socio-economic factors affecting the region.which was crucial for effective ecological conservation and land-use planning.Enhanced the effectiveness of policy formulation and land use plan-ning.The results show that the ESV of the Northeast Forest Belt exhibits an overall increasing trend from 2005 to 2020,with forests and wetlands contributing the most.However,there are significant differences between forest belts.Driven by natural and socio-economic factors,the ESV of forest belts in Heilongjiang and Jilin provinces showed significant growth.In contrast,the ESV of Forest Belts in Liaoning and Inner Mongolia of China remains relatively stable,but the spatial differentiation within these regions is characterized by significant clustering of high-value and low-value areas.Furthermore,climate regulation and hydrological regulation services were identified as the most important ecological functions in the Northeast Forest Belt,contributing greatly to regional ecological stability and human well-being.The ESV in the Northeast Forest Belt is improved during the study period,but the stability of the ecosystem is still chal-lenged by the dual impacts of natural and socio-economic factors.To further optimize regional land use planning and ecological protection policies,it is recommended to prior-itize the conservation of high-ESV areas,enhance ecological restoration efforts for wetlands and forests,and reasonably control the spatial layout of urban expansion and agricul-tural development.Additionally,this study highlights the importance of tailored ecological compensation policies and strategic land-use planning to balance environmental protec-tion and economic growth.展开更多
In the era of the digital economy,digital trade has demonstrated strong vitality,becoming a crucial driving force for the highquality development of national and regional economies.However,understanding the resilience...In the era of the digital economy,digital trade has demonstrated strong vitality,becoming a crucial driving force for the highquality development of national and regional economies.However,understanding the resilience of digital trade in the face of external crises is an important topic.Taking the backdrop of Sino-US trade friction,this paper constructs a resilience index system for digital trade.It utilizes entropy method,kernel density estimation,and ArcGIS mapping to calculate and visually analyze the resilience of China’s digital trade from 2017 to 2021.Additionally,a Tobit model is constructed to explore the main influencing factors of digital trade resilience patterns.The research findings indicate:1)temporally,during the period of Sino-US trade friction,China’s digital trade resilience shows an overall upward trend,but there are regional differences in resilience levels across the country,with a severe polarization phenomenon.2)Spatially,high resilience is observed in the eastern and central regions of China,while the western and northeastern regions exhibit low resilience.3)From a dimensional perspective,the resistance of digital trade resilience displays a spatial distribution of high values in the east and low values in the west.The recovery force is aggregated along coastal areas,and the renewal force tends to aggregate along the eastern coastline.4)Factors such as economic scale,industrial structure,urbanization rate,government fiscal expenditure,and technological talents significantly promote the enhancement of digital trade resilience.This study reveals the dynamic characteristics and influencing factors of digital trade resilience in responding to external shocks,providing theoretical basis and policy suggestions for enhancing digital trade resilience,and promoting high-quality economic development in China.展开更多
文摘This paper thoroughly explores the multifaceted factors influencing the efficacy of Chinese medicinals and categorizes them into three main groups:medicinal related factors,patient related factors,and practitioner related factors.Regarding medicinal related factors,the place of origin,growing environment,harvesting time,storage conditions,quality control,dosage form selection,compatibility of medicinals,precise dosing,decoction methods,and administration routes all significantly impact efficacy.The place of origin determines the authenticity of medicinals,the growing environment affects their composition,harvesting time influences potency,improper storage leads to deterioration,quality control forms the foundation of efficacy,dosage forms and compatibility of medicinals affect absorption,dosing and decoction methods require precision,and administration routes should be tailored to individuals.Patient related factors include psychological state,individual differences,background,and disease condition.Psychological state affects treatment compliance,individual differences determine medicine responses,background influences patients’understanding of Chinese medicinals,and disease condition directly reflects efficacy.Practitioner related factors encompass theoretical knowledge,clinical experience,inherited practices,psychological state,and professional ethics.Theoretical knowledge guides medication use,clinical experience enhances efficacy,inherited practices influence prescribing styles,psychological state affects doctor–patient communication,and professional ethics ensure medical quality.These interrelated factors collectively influence the efficacy of Chinese medicinals,emphasizing the need for comprehensive consideration in clinical applications to achieve optimal therapeutic outcomes.
文摘Understanding crash contributing factors is essential in safety management and improvement. These factors drive investment decisions, policies, regulations, and other safety-related initiatives. This paper analyzes factors that contribute to crash occurrence based on two national datasets in the United States (CISS and NASS-CDS) for the years 2017-2022 and 2010-2015, respectively. Three taxonomies were applied to enhance understanding of the various crash contributing factors. These taxonomies were developed based on previous research and practice and involved different groupings of human factors, vehicle factors, and roadway and environmental factors. Statistics for grouping the different types of factors and statistics for specific factors are provided. The results indicate that human factors are present in over 95% of crashes, roadway and environmental factors are present in over 45% of crashes, and vehicle factors are present in less than 2% of crashes. Regarding factors related to human error and vehicle maintenance, speeding is involved in over 25% of crashes, distraction is involved in over 20% of crashes, alcohol and drugs are involved in over 9% of crashes, and vehicle maintenance is involved in approximately 0.45% of crashes. Approximately 4.4% of crashes involve a driver who “looked but did not see.” Weather is involved in over 13% of crashes. Conclusions: The findings indicate that, consistent with previous research, human factors or human error are present in around 95% of crashes. Infrastructure and environmental factors contribute to about 45% of crashes. Vehicle factors contribute to only 1.67% - 1.71% of crashes. The results from this study could potentially be used to inform future safety management and improvement activities, including policy-making, regulation development, safe systems and systemic safety approaches to safety management, and other engineering, education, emergency response, enforcement, evaluation, and encouragement activities. The findings could also be used in the development of future Driver Assistance Technologies (DAT) systems and in enhancing existing technologies.
基金suported by the National High Level Hospital Clinical Research Funding(2022-NHLHCRF-LX-02-03,2023-NHLHCRF-YXHZ-ZRZD-06)Ministry ofScience and Technology of the People's Republic ofChina,and National Natural Science Foundation ofChina(82071943,82273523).
文摘Background:To evaluate sex‐related differences in the risk factors associated with nonhealing or recurrence of hyper-thyroidism(NHRH)in patients with Graves'disease(GD)treated with radioactive iodine.Methods:In total,285 patients were enrolled.Data on radioactive iodine(RAI)dosage,ultrasound indexes of the thyroid,and other clinical factors were collected.Patients were divided into NHRH and non‐NHRH(hypothyroidism or euthyroidism)groups based on treatment outcomes.Univariate and multivariate weighted logistic regression analyses were used to identify factors associated with NHRH.Sex‐specific analyses of these risk factors were also conducted.Results:There were no significant differences between the two groups in terms of sex,thyroid shear wave elastography velocity values,or pretreatment serum free thyroxine(FT4)levels.Thyroid volume and age were independently associated with NHRH,with the odds of NHRH gradually decreasing as age increased.In subgroup analyses,both age and thyroid volume were independent risk factors for NHRH in female patients(p<0.05),while in male patients,only FT4 was independently associated with NHRH(p<0.05).Conclusions:In patients of different sexes,the influence of thyroid volume,age,and FT4 on treatment outcomes exhibits distinct patterns.
文摘Background:The accurate identification of cardiac abnormalities is essential for proper diagnosis and effective treatment of cardiovascular diseases.Method:This work introduces an advanced methodology for detecting cardiac abnormalities and estimating electrocardiographic age(ECG Age)using sophisticated signal processing and deep learning techniques.This study looks at six main heart conditions found in 12-lead electrocardiogram(ECG)data.It addresses important issues like class imbalances,missing lead scenarios,and model generalizations.A modified residual neural network(ResNet)architecture was developed to enhance the detection of cardiac abnormalities.Results:The proposed ResNet demonst rated superior performance when compared with two linear models and an alternative ResNet architectures,achieving an overall classification accuracy of 91.25%and an F1 score of 93.9%,surpassing baseline models.A comprehensive lead loss analysis was conducted,evaluating model performance across 4096 combinations of missing leads.The results revealed that pulse rate-based factors remained robust with up to 75%lead loss,while block-based factors experienced significant performance declines beyond the loss of four leads.Conclusion:This analysis highlighted the importance of addressing lead loss impacts to maintain a robust model.To optimize performance,targeted training approaches were developed for different conditions.Based on these insights,a grouping strategy was implemented to train specialized models for pulse rate-based and block-based conditions.This approach resulted in notable improvements,achieving an overall classification accuracy of 95.12%and an F1 score of 95.79%.
文摘Nerve trauma commonly results in chronic neuropathic pain. This is by triggering the release of proinflammatory mediators from local and invading cells that induce inflammation and nociceptive neuron hyperexcitability. Even without apparent inflammation, injury sites are associated with increased inflammatory markers. This review focuses on how it might be possible to reduce neuropathic pain by reducing inflammation. Physiologically, pain is resolved by a combination of the out-migration of pro-inflammatory cells from the injury site, the down-regulation of the genes underlying the inflammation, up-regulating genes for anti-inflammatory mediators, and reducing nociceptive neuron hyperexcitability. While various techniques reduce chronic neuropathic pain, the best are effective on < 50% of patients, no technique reliably or permanently eliminates neuropathic pain. This is because most techniques are predominantly aimed at reducing pain, not inflammation. In addition, while single factors reduce pain, increasing evidence indicates significant and longer-lasting pain relief requires multiple factors acting simultaneously. Therefore, it is not surprising that extensive data indicate that the application of platelet-rich plasma provides more significant and longer-lasting pain suppression than other techniques, although its analgesia is neither complete nor permanent. However, several case reports indicate that platelet-rich plasma can induce permanent neuropathic pain elimination when the platelet concentration is significantly increased and is applied to longer nerve lengths. This review examines the primary triggers of the development and maintenance of neuropathic pain and techniques that reduce chronic neuropathic pain. The application of plateletrich plasma holds great promise for providing complete and permanent chronic neuropathic pain elimination.
文摘As a major global public health issue,tuberculosis is closely related to multiple socio-ecological factors in its epidemiological patterns~([1]).China,as a high-burden country for tuberculosis,exhibits regional variations in the distribution of the tuberculosis epidemic.To enhance the efficiency of prevention and control,its strategies are undergoing a transition toward regionally differentiated approaches~([2]).
基金supported by the National Natural Science Foundation of China(Grant Nos.11875122,12175025,and 12147102)Tongling University Talent Program(Grant No.R23100)。
文摘In this paper,we study the ρ-meson electromagnetic form factors(EMFFs)within the framework of the light-front quark model.The physical form factors G_(C,M,Q)(Q^(2))of the ρ-meson,as well as the charged square radius<r^(2)>,the magnetic moment μ,and the quadrupole moment Q,are calculated,which describe the behaviors of EMFFs at zero momentum transfer.Using the type-Ⅱ replacement,we find that the zero-mode does contribute zero to the matrix element S_(00)^(+).It is found that the“M→M_(0)”replacement improves the angular condition remarkably,which permits different prescriptions of ρ-meson EMFFs to give the consistent results.The residual tiny violation of angular condition needs other explanations beyond the zero-mode contributions.Our results indicate that the relativistic effects or interaction internal structure are weaken in the zero-binding limit.This work is also applicable to other spin-1 particles.
基金supported by the Guangxi Natural Science Foundation Program(2022GXNSFAA035583,2021GXNSFBA196052)the National Natural Science Foundation of China(32060305,32460270).
文摘Most research on carbon storage in forests has focused on qualitative studies of carbon storage and influ-encing factors rather than on quantifying the effect of the spatial distribution of carbon storage and of its influencing factors at different scales.Here we described the spatial dis-tribution of aboveground carbon storage(ACS)in a 20-ha plot in a subtropical evergreen broad-leaved forest to evalu-ate and quantify the relative effects of biotic factors(species diversity and structural diversity)and abiotic factors(soil and topographic factors)on ACS at different scales.Scale effects of the spatial distribution of ACS were significant,with higher variability at smaller scales,but less at larger scales.The distribution was also spatially heterogeneous,with more carbon storage on north-and east-facing slopes than on south-and west-facing slopes.At a smaller scale,species diversity and structural diversity each had a direct positive impact on ACS,but soil factors had no significant direct impact.At increasing scales,topographic and soil fac-tors gradually had a greater direct influence,whereas the influence of species diversity gradually decreased.Structural diversity had the greatest impact,followed by topographic factors and soil factors,while species diversity had a rela-tively smaller impact.These findings suggest studies on ACS in subtropical evergreen broadleaf forests in southern China should consider scale effects,specifically on the heterogene-ity of ACS distribution at small scales.Studies and conser-vation efforts need to focus on smaller habitat types with particular emphasis on habitat factors such as aspect and soil conditions,which have significant influences on community species diversity,structural diversity,and ACS distribution.
基金Supported by the Joint Funds of the National Natural Science Foundation of China,No.U23A20434National Natural Science Foundation of China,No.82301738,No.82371535,and No.82171518+1 种基金the National Key Research and Development Program of China,No.2021YFF1201204the Science and Technology Innovation Program of Hunan Province,No.2023RC3083.
文摘BACKGROUND Antenatal depression is a disabling mental disorder among pregnant women and may cause adverse outcomes for both the mother and the offspring.Early identification and intervention of antenatal depression can help to prevent adverse outcomes.However,there have been few population-based studies focusing on the association of social and obstetric risk factors with antenatal depression in China.AIM To assess the sociodemographic and obstetric factors of antenatal depression and compare the network structure of depressive symptoms across different risk levels based on a large Chinese population.METHODS The cross-sectional survey was conducted in Shenzhen,China from 2020 to 2024.Antenatal depression was assessed using the Chinese version of the Edinburgh Postnatal Depression Scale(EPDS),with a score of≥13 indicating the presence of probable antenatal depression.Theχ2 test and binary logistic regression were used to identify the factors associated with antenatal depression.Network analyses were conducted to investigate the structure of depressive symptoms across groups with different risk levels.RESULTS Among the 44220 pregnant women,the prevalence of probable antenatal depression was 4.4%.An age≤24 years,a lower level of education(≤12 years),low or moderate economic status,having a history of mental disorders,being in the first trimester,being a primipara,unplanned pregnancy,and pregnancy without pre-pregnancy screening were found to be associated with antenatal depression(all P<0.05).Depressive symptom networks across groups with different risk levels revealed robust interconnections between symptoms.EPDS8("sad or miserable")and EPDS4("anxious or worried")showed the highest nodal strength across groups with different risk levels.CONCLUSION This study suggested that the prevalence of antenatal depression was 4.4%.Several social and obstetric factors were identified as risk factors for antenatal depression.EPDS8("sad or miserable")and EPDS4("anxious or worried")are pivotal targets for clinical intervention to alleviate the burden of antenatal depression.Early identification of highrisk groups is crucial for the development and implementation of intervention strategies to improve the overall quality of life for pregnant women.
文摘Depression is a severe mood disorder characterized by complex suicide mechanisms that involve a multitude of psychosocial and biological fac-tors.This paper presents a comprehensive analysis of the psychosocial factors influencing suicidal behavior in depression,including social support,life events,depressive symptoms,and personality traits,as well as biological factors such as brain-derived neurotrophic factor(BDNF),erotonin(5-TH)system dysfunction,and hypothalam-ic-pituitary-adrenal(HPA)axis abnormalities.Collectively,these factors significantly influence an individual’s risk of suicide,with biological factors serving as potential biomarkers for suicidal actions and psychosocial factors underscoring the impact of environmental and individual experiences.Understanding the interaction of these factors is crucial for comprehending and preventing suicidal behavior in depression.Despite considerable progress,current studies have limitations,particularly regarding the unclear interaction mechanisms between psychosocial and biological factors and a predominant focus on adult populations,with insufficient comprehensive studies on adolescents.
文摘Introduction: Multiple endocrine and metabolic abnormalities, particularly overweight and obesity, have emerged as significant global public health concerns. This paper examines the impact of these conditions on health outcomes and underscores the necessity for comprehensive strategies to address them. Background: Overweight and obesity have been observed in patients with human immunodeficiency virus (HIV) both before and after the initiation of antiretroviral therapy. This study investigates the risk factors associated with overweight and obesity in HIV-infected patients. Methods: A total of 492 HIV-infected patients, both treatment-naïve and those undergoing treatment, were recruited from Yaoundé Central Hospital in Cameroon. Demographic, anthropometric, and biochemical data were collected from each patient. Blood pressure and abdominal fat measurements were also taken. Metabolic syndrome was defined according to IDF criteria. Patients were categorized into two weight status groups: underweight/normal weight and overweight/obese. Results: The prevalence of overweight and obesity was found to be 27.5% and 8.5%, respectively, with only 6.1% of patients being underweight. Abdominal obesity, systolic/diastolic blood pressure, metabolic syndrome, and CD4 cell counts were associated with risk factors in overweight and obese patients. These parameters should be considered when investigating metabolic disorders in HIV-infected patients, as in the general population. Conclusion: Our study indicates a high risk of developing metabolic syndrome among overweight/obese individuals, who were 5.7 times more likely to have metabolic syndrome compared to those of normal weight/underweight. These findings support the hypothesis that overweight and obesity are also prevalent in HIV-infected patients and they are risk factors that have to be taken into consideration to better manage this issue. These results may provide essential information on the fact that being underweight is not the only issue to take into consideration in these patients but that overweight/obesity is now present. Prevention and management strategies should consider both aspects.
文摘The image of China in The Painted Veil by Maugham is complicated and diversified.On the one hand,it predicts numerous representative sceneries of the Chinese village,unveiling the exotic natural sceneries of China.Moreover,the spirit of Taoism is stated in the novel,unveiling the mysterious culture of Chinese’concern about the harmony of man and nature,which displays Maugham’s admiration for Chinese exotic flavors.On the other hand,China is depicted as poor and undeveloped,a country stricken by epidemic diseases and opium smokers.This article aims to analyze the factors affecting Maugham’s images of China from the subjective and objective perspectives.Chapter two profoundly explores the significant influence of Maugham’s life experience,religious belief and personal values on his individual images of China.Chapter three expounds the effective factors of social thoughts and economy.From the exploration,it is apparent that the formation of the image of China in The Painted Veil is firstly influenced by the life experience,individual values and religious belief of Maugham.Literary writing is actually a miniature and indirect representation of the author’s life experience.
文摘BACKGROUND At present,the influencing factors of social function in patients with residual depressive symptoms are still unclear.Residual depressive symptoms are highly harmful,leading to low mood in patients,affecting work and interpersonal communication,increasing the risk of recurrence,and adding to the burden on families.Studying the influencing factors of their social function is of great significance.AIM To explore the social function score and its influencing factors in patients with residual depressive symptoms.METHODS This observational study surveyed patients with residual depressive symptoms(case group)and healthy patients undergoing physical examinations(control group).Participants were admitted between January 2022 and December 2023.Social functioning was assessed using the Sheehan Disability Scale(SDS),and scores were compared between groups.Factors influencing SDS scores in patients with residual depressive symptoms were analyzed by applying multiple linear regression while using the receiver operating characteristic curve,and these RESULTS The SDS scores of the 158 patients with depressive symptoms were 11.48±3.26.Compared with the control group,the SDS scores and all items in the case group were higher.SDS scores were higher in patients with relapse,discon-tinuous medication,drug therapy alone,severe somatic symptoms,obvious residual symptoms,and anxiety scores≥8.Disease history,medication compliance,therapy method,and residual symptoms correlated positively with SDS scores(r=0.354,0.414,0.602,and 0.456,respectively).Independent influencing factors included disease history,medication compliance,therapy method,somatic symptoms,residual symptoms,and anxiety scores(P<0.05).The areas under the curve for predicting social functional impairment using these factors were 0.713,0.559,0.684,0.729,0.668,and 0.628,respectively,with sensitivities of 79.2%,61.8%,76.8%,81.7%,63.6%,and 65.5%and specificities of 83.3%,87.5%,82.6%,83.3%,86.7%,and 92.1%,respectively.CONCLUSION The social function scores of patients with residual symptoms of depression are high.They are affected by disease history,medication compliance,therapy method,degree of somatic symptoms,residual symptoms,and anxiety.
文摘BACKGROUND: This study aimed to explore the risk factors associated with intensive care unitacquired weakness(ICU-AW) in critically ill patients at risk of malnutrition and to evaluate the efficacy of early enteral nutrition(EEN) and the role of biomarkers in managing ICU-AW.METHODS: This retrospective, observational cohort study included 180 patients at risk of malnutrition admitted to the emergency intensive care unit of the First Affiliated Hospital of Xiamen University Hospital from January 2022 to December 2023. Patients were divided into ICU-AW group and non-ICU-AW group according to whether they developed ICU-AW, or categorized into EEN and parenteral nutrition(PN) groups according to nutritional support. ICU-AW was diagnosed using the Medical Research Council score. The primary outcome was the occurrence of ICU-AW.RESULTS: The significant factors associated with ICU-AW included age, sex, type of nutritional therapy, mechanical ventilation(MV), body mass index(BMI), blood urea nitrogen(BUN), and creatinine(Cr) levels(P<0.05). The PN group developed ICU-AW earlier than did the EEN group, with a significant difference observed(log-rank P<0.001). Among biomarkers for ICU-AW, the mean prealbumin(PAB)/C-reactive protein(CRP) ratio had the highest diagnostic accuracy(area under the curve [AUC] 0.928, 95% confidence interval [95% CI] 0.892–0.946), surpassing the mean Cr/BUN ratio(AUC 0.740, 95% CI 0.663–0.819) and mean transferrin levels(AUC 0.653, 95% CI 0.574–0.733).CONCLUSION: Independent risk factors for ICU-AW include female sex, advanced age, PN, MV, lower BMI, and elevated BUN and Cr levels. EEN may potentially delay ICU-AW onset, and the PAB/CRP ratio may be an effective diagnostic marker for this condition.
文摘BACKGROUND Lung cancer(LC)is one of the most prevalent cancers globally,with a high incidence among the elderly population.Elderly patients,particularly those with diabetes mellitus,are at an increased risk of postoperative complications,in-cluding pulmonary infections,due to weakened immune function and metabolic abnormalities.Postoperative pulmonary infection(PPI)is a predominant com-plication after thoracoscopic radical resection of LC,significantly affecting patient outcomes and increasing healthcare burdens.Determining risk factors for PPI in this vulnerable population is crucial for improving surgical outcomes and redu-cing infection rates.AIM To develop and validate a predictive model for PPI in elderly patients with dia-betes undergoing thoracoscopic radical resection for LC and to assess its reliability and validity.METHODS This retrospective study included 212 patients with LC who received treatment at our hospital from March 2015 to March 2022.General clinical information,sur-gical treatment details,and laboratory test results were collected and analyzed.Patients were grouped according to infection occurrence during the postoperative hospitalization period.Risk factors for PPIs were determined through logistic regression analysis,and a nomogram prediction model was established using R software to assess its predictive accuracy and performance.RESULTS Among the 212 patients[median age:72 years(interquartile range:60-82 years)],41 developed PPI(19.34%),with Gram-negative bacteria being the predominant pathogens(64.14%).Factors,such as age of≥70 years,presence of respiratory diseases,maximum tumor diameter of≥4 cm,stages II-III,receiving neoadjuvant chemotherapy of≥2 times preoperatively,surgery duration of≥3 hours,chest drainage tube placement duration of≥3.5 days,preoperative fasting blood glucose levels,hemoglobin A1c(HbA1c)levels,and multi-leaf resection,were markedly higher in the infection group than in the non-infection group.Conversely,forced expiratory volume in 1 second(FEV1)of≥80%and albumin(Alb)levels were lower in the infection group.Multivariate logistic regression analysis revealed that receiving neoadjuvant chemotherapy of≥2 times[odds ratio(OR)=2.987;P=0.036],maximum tumor diameter of≥4 cm(OR=3.959;P=0.013),multi-leaf resection(OR=3.18;P=0.036),preoperative FEV1 of≤80%(OR=3.305;P=0.029),and high HbA1c levels(OR=2.39;P=0.003)as key risk factors for PPI,whereas high Alb levels(OR=0.507;P<0.001)was protective.The nomogram model demonstrated excellent diagnostic ability(area under the curve=0.901,0.915),and calibration curves and decision curve analysis revealed good predictive performance and clinical applicability of the model.CONCLUSION The primary pathogens of PPI in elderly patients with diabetes and LC undergoing thoracoscopic radical resection are Gram-negative bacteria.The nomogram model,based on preoperative neoadjuvant chemotherapy cycles,maximum tumor diameter,range of resection,and preoperative FEV1,Alb,and HbA1c levels,shows high clinical value in predicting the risk of PPI in this patient population.
文摘BACKGROUND Liver transplant(LT)recipients are susceptible to carbapenem-resistant Klebsiella pneumoniae(CRKP)infections.Comprehensive research addressing the incidence,timing,infection sites,resistance patterns,treatment options,and associated risk factors among LT recipients with CRKP is now lacking.AIM To assess the incidence,resistance,therapy,and risk factors of CRKP infections post-LT,and to evaluate the impact of them on prognosis.METHODS A retrospective study was conducted,including 430 consecutive patients who underwent LT between January 2015 and June 2023.This study aimed to investigate the risk factors for CRKP infections and their influence on outcomes using logistic regression analysis.RESULTS Among the 430 patients who underwent LT,20(4.7%)experienced at least one documented CRKP infection within 3 months post-transplantation.The median time from LT to the onset of CRKP infections was 6.5 days.The lungs and bloodstream were the most common sites of CRKP infections.CRKP isolates were relatively susceptible to ceftazidime/avibactam(93.7%),polymyxin B(90.6%),and tigecycline(75.0%)treatment.However,all isolates were resistant to piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,meropenem,and levofloxacin treatment.Recipients with CRKP infections had a mortality rate of 35%,the rate was 12.5%for those receiving ceftazidime/avibactam therapy.Multivariate analysis identified female sex[odds ratio(OR)=3.306;95%confidence interval(CI):1.239-8.822;P=0.017],intraoperative bleeding≥3000 mL(OR=3.269;95%CI:1.018-10.490;P=0.047),alanine aminotransferase on day 1 post-LT≥1500 U/L(OR=4.370;95%CI:1.686-11.326;P=0.002),and post-LT mechanical ventilation(OR=2.772;95%CI:1.077-7.135;P=0.035)as significant variables associated with CRKP.CRKP infections were related to an intensive care unit length(ICU)of stay≥7 days and 6-month all-cause mortality post-LT.CONCLUSION CRKP infections were frequent complications following LT,with poor associated outcomes.Risk factors for post-LT CRKP infections included female sex,significant intraoperative bleeding,elevated alanine aminotransferase levels,and the need for mechanical ventilation.CRKP infections negatively impacted survival and led to prolonged ICU stays.
文摘BACKGROUND The development of hepatocellular carcinoma(HCC)is influenced by multiple factors.Interventional therapy offers an effective treatment option for patients with unresectable intermediate-to-advanced HCC.Interventional therapy can induce electrocardiographic(ECG)abnormalities that may be associated with liver dysfunction,electrolyte disorders,and cardiac injury.AIM To explore the ECG alterations and determinants following interventional therapy in patients with HCC.METHODS Sixty patients undergoing interventional treatment for liver cancer were selected as study participants.According to the results of the dynamic ECG examination 1 day after surgery,the patients were divided into an abnormal group(n=21)and a nonabnormal group(n=39).With the help of dynamic ECG examination,the ECG parameters were compared and the baseline data of patients was recorded in the two groups.RESULTS The 24 hours QT interval variability,24 hours normal atrial polarization to ventricular polarization(R-R)interval(standard deviation),24 hours consecutive 5 minutes normal R-R interval,and 24 hours continuous 5 minutes normal R-R interval(standard deviation mean)were lower than patients in the nonabnormal group(P<0.05).The logistic analysis showed that age>60 years,liver function grade B,and postoperative body temperature 38°C were risk factors for abnormal dynamic electrocardiogram in patients with liver cancer intervention(P<0.05).CONCLUSION Interventional therapy for HCC can lead to ECG abnormalities,underscoring the clinical need for enhanced cardiac monitoring to mitigate myocardial complications.
基金supported by the‘Double First-Class’Construction Specialized Discipline Project at Zhejiang University(No HL2024012).
文摘Objectives:This systematic review and meta-analysis aimed to identify and synthesize the factors correlated with posttraumatic growth(PTG)in patients with colorectal cancer(CRC).Methods:PubMed,Web of Science,Embase,PsycINFO,CINAHL,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang database,China Science and Technology Journal Database(VIP)and SinoMed were searched for studies that reported data on the correlated factors associated with PTG in patients with CRC from inception to September 3,2024.The methodological quality of the included studies was assessed via the Agency for Healthcare Research and Quality(AHRQ)methodology checklist and the Newcastle-Ottawa Scale(NOS).Pearson correlation coefficient(r)was utilized to indicate effect size.Meta-analysis was conducted in R Studio.Results:Thirty-one eligible studies encompassing 6,400 participants were included in this review.Correlated factors were identified to be significantly associated with PTG in patients with CRC including demographic factors:residential area(r=0.13),marital status(r=0.10),employment status(r=0.18),education level(r=0.19),income level(r=0.16);disease-related factors:time since surgery(r=0.17),stoma-related complications(r=0.14),health-promoting behavior(r=0.46),and sexual function(r=0.17);psychosocial factors:confrontation coping(r=0.68),avoidance coping(r=-0.65),deliberate rumination(r=0.56),social support(r=0.47),family function(r=0.50),resilience(r=0.53),selfefficacy(r=0.91),self-compassion(r=-0.32),psychosocial adjustment(r=0.39),gratitude(r=0.45),stigma(r=-0.65),self-perceived burden(r=-0.31),fear of cancer recurrence(r=-0.45);and quality of life(r=0.32).Conclusions:This meta-analysis identified 23 factors associated with PTG in CRC patients.Medical workers can combine those relevant factors from the perspective of positive psychology,further explore the occurrence and development mechanism of PTG,and establish targeted interventions to promote PTG.
基金funded by the Central University D Project(HFW230600022)National Natural Science Foundation of China(71973021)+1 种基金National Natural Science Foundation Youth Funding Project(72003022)Heilongjiang Province University Think Tank Open Topic(ZKKF2022173).
文摘The scientific assessment of ecosystem ser-vice value(ESV)plays a critical role in regional ecologi-cal protection and management,rational land use planning,and the establishment of ecological security barriers.The ecosystem service value of the Northeast Forest Belt from 2005 to 2020 was assessed,focusing on spatial–temporal changes and the driving forces behind these dynamics.Using multi-source data,the equivalent factor method,and geo-graphic detectors,we analyzed natural and socio-economic factors affecting the region.which was crucial for effective ecological conservation and land-use planning.Enhanced the effectiveness of policy formulation and land use plan-ning.The results show that the ESV of the Northeast Forest Belt exhibits an overall increasing trend from 2005 to 2020,with forests and wetlands contributing the most.However,there are significant differences between forest belts.Driven by natural and socio-economic factors,the ESV of forest belts in Heilongjiang and Jilin provinces showed significant growth.In contrast,the ESV of Forest Belts in Liaoning and Inner Mongolia of China remains relatively stable,but the spatial differentiation within these regions is characterized by significant clustering of high-value and low-value areas.Furthermore,climate regulation and hydrological regulation services were identified as the most important ecological functions in the Northeast Forest Belt,contributing greatly to regional ecological stability and human well-being.The ESV in the Northeast Forest Belt is improved during the study period,but the stability of the ecosystem is still chal-lenged by the dual impacts of natural and socio-economic factors.To further optimize regional land use planning and ecological protection policies,it is recommended to prior-itize the conservation of high-ESV areas,enhance ecological restoration efforts for wetlands and forests,and reasonably control the spatial layout of urban expansion and agricul-tural development.Additionally,this study highlights the importance of tailored ecological compensation policies and strategic land-use planning to balance environmental protec-tion and economic growth.
基金Under the auspices of National Natural Science Foundation of China(No.42471205)the General Scientific Research Project of Zhejiang Provincial Department of Education(No.2024JYTYB12)the Philosophy and Social Science Planning Project of Zhejiang Province(No.23NDJC109YB)。
文摘In the era of the digital economy,digital trade has demonstrated strong vitality,becoming a crucial driving force for the highquality development of national and regional economies.However,understanding the resilience of digital trade in the face of external crises is an important topic.Taking the backdrop of Sino-US trade friction,this paper constructs a resilience index system for digital trade.It utilizes entropy method,kernel density estimation,and ArcGIS mapping to calculate and visually analyze the resilience of China’s digital trade from 2017 to 2021.Additionally,a Tobit model is constructed to explore the main influencing factors of digital trade resilience patterns.The research findings indicate:1)temporally,during the period of Sino-US trade friction,China’s digital trade resilience shows an overall upward trend,but there are regional differences in resilience levels across the country,with a severe polarization phenomenon.2)Spatially,high resilience is observed in the eastern and central regions of China,while the western and northeastern regions exhibit low resilience.3)From a dimensional perspective,the resistance of digital trade resilience displays a spatial distribution of high values in the east and low values in the west.The recovery force is aggregated along coastal areas,and the renewal force tends to aggregate along the eastern coastline.4)Factors such as economic scale,industrial structure,urbanization rate,government fiscal expenditure,and technological talents significantly promote the enhancement of digital trade resilience.This study reveals the dynamic characteristics and influencing factors of digital trade resilience in responding to external shocks,providing theoretical basis and policy suggestions for enhancing digital trade resilience,and promoting high-quality economic development in China.
