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
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
BACKGROUND Post-transplant tertiary hyperparathyroidism(PT-tHPT)is a well-recognized complication following kidney transplantation,characterized by persistent excessive secretion of parathyroid hormone(PTH)despite imp...BACKGROUND Post-transplant tertiary hyperparathyroidism(PT-tHPT)is a well-recognized complication following kidney transplantation,characterized by persistent excessive secretion of parathyroid hormone(PTH)despite improved renal function.It is potentially associated with an increased risk of cardiovascular events,renal osteodystrophy,pathologic fractures,graft loss,and mortality.AIM To evaluate the incidence,risk factors,and outcomes of PT-tHPT amongst kidney transplant recipients.METHODS A total of 887 transplant recipients who underwent transplantation between 2000 and 2020 were evaluated.Univariable and multivariable logistic regression was performed to determine the predictors of tertiary hyperparathyroidism.Graft and recipient outcomes were assessed using multivariable Cox regression.A separate multivariable Cox regression was performed to determine the effect of treatment strategies on outcomes.RESULTS PT-tHPT,defined as elevated PTH(>65 ng/L)and persistent hypercalcemia(>2.60 mmol/L),was diagnosed in 14%of recipients.Risk factors for PT-tHPT included older age[odds ratio(OR)=1.36,P<0.001],Asian ethnicity(OR=0.33,P=0.006),total ischemia time(OR=1.03,P=0.048 per hour),pre-transplant serum calcium(OR=1.38,P<0.001)per decile increase,pre-transplant PTH level(OR=1.31,P<0.001)per decile increase,longer dialysis duration(OR=1.12,P=0.002)per year,history of acute rejection(OR=2.37,P=0.012),and slope of estimated glomerular filtration rate change(OR=0.91,P=0.001).There were a 3.4-fold higher risk of death-censored graft loss and a 1.9-fold greater risk of recipient death with PT-tHPT.The three treatment strategies of conservative management,calcimimetic and parathyroidectomy did not significantly change the graft or patient outcome.CONCLUSION Pretransplant elevated calcium and PTH levels,older age and dialysis duration are associated with PT-tHPT.While PT-tHPT significantly affects graft and recipient survival,the treatment strategies did not affect survival.展开更多
BACKGROUND Ischemic stroke is one of the leading global causes of disability and death.Despite advances in modern medical technology that improve acute treatment and rehabilitation measures,post-stroke anxiety and dep...BACKGROUND Ischemic stroke is one of the leading global causes of disability and death.Despite advances in modern medical technology that improve acute treatment and rehabilitation measures,post-stroke anxiety and depression(PSD)do not receive sufficient attention.AIM To systematically evaluate risk factors and early identification markers for PSD for more precise screening and intervention strategies in clinical practice.METHODS This retrospective study analyzed clinical data from 112 patients with ischemic stroke admitted between January 2022 and December 2024.Based on assessments using the Hamilton Rating Scale for Anxiety(HAMA)and Hamilton Rating Scale for Depression(HAMD)at 2 weeks(±3 days)post-stroke,patients were classified into the PSD group(HAMA≥7 and/or HAMD≥7)and the non-PSD group(HAMA<7 and HAMD<7).Observation indicators included psychological assessment,demographic and clinical characteristics,stroke-related clinical indicators,neuroimaging assessments,and laboratory biomarkers.Multivariate logistic regression analysis was used to identify independent risk factors for PSD,and receiver operating characteristic curve analysis was used to evaluate the diagnostic value of potential biomarkers.RESULTS Of the 112 patients,46(41.1%)were diagnosed with PSD.Multivariate analysis identified five independent risk factors:Female gender[Odds ratio(OR)=2.32,95%confidence interval(CI):1.56-3.45],history of mental disorders prior to stroke(OR=3.17,95%CI:1.89-5.32),infarct location in the frontal lobe or limbic system(OR=2.86,95%CI:1.73-4.71),stroke severity with National Institutes of Health Stroke Scale≥8 at admission(OR=2.54,95%CI:1.62-3.99),and low social support(Social Support Rating Scale<35,OR=2.18,95%CI:1.42-3.36).Subgroup analysis showed that depression patients more commonly had left hemisphere lesions(68.4%vs 45.2%),while anxiety patients more frequently presented with right hemisphere lesions(59.5%vs 39.5%).The PSD group exhibited larger infarct volumes(8.7 cm^(3) vs 5.3 cm^(3)),more severe white matter hyperintensities,and more pronounced frontal lobe atrophy.Analysis of inflammatory markers showed significantly elevated levels of interleukin-6(7.8 pg/mL vs 4.5 pg/mL)and tumor necrosis factor-alpha(15.6 pg/mL vs 9.8 pg/mL)in the PSD group,while hypothalamicpituitary-adrenal axis function assessment revealed higher cortisol levels(386.5±92.3 nmol/L vs 328.7±75.6 nmol/L)and flattened diurnal rhythm in the PSD group.CONCLUSION PSD is a complex neuropsychiatric consequence of stroke involving disruption of the frontal-limbic circuitry,neuroinflammatory responses,and dysfunction of the hypothalamic-pituitary-adrenal axis.展开更多
Landslides pose a formidable natural hazard across the Qinghai-Tibet Plateau(QTP),endangering both ecosystems and human life.Identifying the driving factors behind landslides and accurately assessing susceptibility ar...Landslides pose a formidable natural hazard across the Qinghai-Tibet Plateau(QTP),endangering both ecosystems and human life.Identifying the driving factors behind landslides and accurately assessing susceptibility are key to mitigating disaster risk.This study integrated multi-source historical landslide data with 15 predictive factors and used several machine learning models—Random Forest(RF),Gradient Boosting Regression Trees(GBRT),Extreme Gradient Boosting(XGBoost),and Categorical Boosting(CatBoost)—to generate susceptibility maps.The Shapley additive explanation(SHAP)method was applied to quantify factor importance and explore their nonlinear effects.The results showed that:(1)CatBoost was the best-performing model(CA=0.938,AUC=0.980)in assessing landslide susceptibility,with altitude emerging as the most significant factor,followed by distance to roads and earthquake sites,precipitation,and slope;(2)the SHAP method revealed critical nonlinear thresholds,demonstrating that historical landslides were concentrated at mid-altitudes(1400-4000 m)and decreased markedly above 4000 m,with a parallel reduction in probability beyond 700 m from roads;and(3)landslide-prone areas,comprising 13%of the QTP,were concentrated in the southeastern and northeastern parts of the plateau.By integrating machine learning and SHAP analysis,this study revealed landslide hazard-prone areas and their driving factors,providing insights to support disaster management strategies and sustainable regional planning.展开更多
BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery...BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery speed and quality of life.Effective prevention of anxiety and depression in elderly patients has become an urgent problem.AIM To investigate the trajectory of anxiety and depression levels in elderly patients after LIF,and the influencing factors.METHODS Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital.General information and surgery-related indices were recorded,and participants completed measures of psychological status,lumbar spine dysfunction,and quality of life.A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels,and unordered multi-categorical logistic regression was used to analyze the influencing factors.RESULTS Three trajectories of change in anxiety level were identified:Increasing anxiety(n=26,10.88%),decreasing anxiety(n=27,11.30%),and stable anxiety(n=186,77.82%).Likewise,three trajectories of change in depression level were identified:Increasing depression(n=30,12.55%),decreasing depression(n=26,10.88%),and stable depression(n=183,76.57%).Regression analysis showed that having no partner,female sex,elevated Oswestry dysfunction index(ODI)scores,and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels,whereas female sex,postoperative opioid use,and elevated ODI scores all contributed to increased depression levels.CONCLUSION During clinical observation,combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention,quickens recovery,and enhances quality of life.展开更多
BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different ...BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different factors.AIM To investigate the key determinants of aseptic loosening,we performed a systematic review and meta-analysis.METHODS A comprehensive search of PubMed,Web of Science,EMBASE,and the Cochrane Library was conducted,encompassing studies from database inception to January 1,2025.Meta-analyses were performed to evaluate factors associated with aseptic loosening following pTHA.Inclusion and exclusion criteria were systematically applied at each stage to ensure methodological transparency and reproducibility.Study quality was assessed using standardized categories.Pooled odds ratio(OR)with corresponding 95%confidence interval were calculated with random-or fixed-effects models to generate reliability estimates,and study heterogeneity was visualized using forest plots.Ten factors,categorized into patient-,surgeon-,and device-related domains,were reviewed and meta-analyzed.Funnel plot analysis demonstrated a relatively symmetrical distribution,suggesting minimal publication bias.RESULTS A meta-analysis of 20 studies(520789 participants)found a pooled prevalence of 1.96%.Significant risk factors for aseptic loosening after pTHA included elevated body mass index(OR=1.116,P<0.001),higher Charlson comorbidity index(OR=1.378,P<0.001),prosthesis-related factors(OR=1.497,P<0.001),and adverse lifestyles(OR=2.198,P=0.037).Protective factors were non-white race(OR=0.445,P<0.001)and favorable genetics(OR=0.723,P<0.001).Male sex increased risk(OR=1.232,P=0.016),while age and anatomy were not significant.Surgical expertise showed a slight protective effect(OR=1.048,P<0.001).A comprehensive understanding of the modifiable and non-modifiable factors contributing to aseptic loosening after pTHA requires consideration of patient-related factors,surgical expertise,and prosthesis characteristics.CONCLUSION The identification of these factors is critical for risk mitigation.High-risk patients should receive targeted counseling regarding individualized profiles.Further studies are warranted to establish clearer causal relationships and identify additional contributing factors.展开更多
The discharge of micro-polluted water from sources such as agricultural runoff,urban stormwater,and treated effluents presents significant challenges to aquatic ecosystems.Constructed wetlands(CWs)have gained recog-ni...The discharge of micro-polluted water from sources such as agricultural runoff,urban stormwater,and treated effluents presents significant challenges to aquatic ecosystems.Constructed wetlands(CWs)have gained recog-nition as an eco-friendly solution for removing pollutants from various wastewater sources and are increasingly applied for micro-polluted water treatment.By reviewing 78 full-scale CW studies from Web of Science,it is summarized that the ranges of ammonium nitrogen(NH4+-N)concentrations in runoff,wastewater treatment plant effluent and polluted river were 0.1–6.6,0.3–12.3,and 0.2–41.1 mg/L,respectively.The ranges of ni-trate nitrogen concentrations were 0.2–14.2,0–5.7,and 0–2.6 mg/L,respectively.Removal efficiencies of CWs for micro-polluted water varied by CW types.The total nitrogen removal efficiencies for subsurface-flow CWs,free-water surface-flow CWs,and hybrid CWs ranged from 27.4%to 66.5%,16.8%to 89.8%,and 19.4%to 88.2%,respectively.The NH4+-N removal efficiencies ranged from 34.2%to 73.6%,38.4%to 89.4%and 13.5%to 94.2%,respectively.Additionally,other factors influencing contaminant removal efficiency such as hydraulic retention time,vegetation types,redox micro-environment and influent water quality were evaluated.Based on these findings,two strategies for improving the purification performance of CWs were proposed:the selection of incorporating electron donor substrates and the optimization of operation parameters.This paper serves as a synthesis of information to guide future research and full-scale CW applications in micro-polluted water treatment.展开更多
AIM:To evaluate the clinical characteristics and risk factors associated with visual prognosis in patients with open globe injuries(OGIs)treated at Vietnam National Eye Hospital.METHODS:A prospective observational stu...AIM:To evaluate the clinical characteristics and risk factors associated with visual prognosis in patients with open globe injuries(OGIs)treated at Vietnam National Eye Hospital.METHODS:A prospective observational study included patients with OGIs treated between June 2023 and June 2024.Data on demographics,injury features,and clinical findings were extracted from medical records.Poor visual outcome was defined as final best-corrected visual acuity(BCVA)worse than 20/400 or no light perception.Multivariable logistic regression was performed to identify independent risk factors.RESULTS:Among 509 patients(636 eyes),the mean age was 35.13y(range 20–51y),and 67.6%were male.After treatment,the proportion of eyes achieving≥20/40 increased from 12.6%to 42.1%,while no light perception decreased from 29.1%to 9.4%.Independent predictors of poor visual outcomes included delayed admission[>4h,odds ratio(OR)=3.33,95%confidence intervals(CI):1.76–6.33,P<0.001],Zone III injury(OR=5.90,95%CI:2.85–12.24,P<0.001),wound length>10 mm(OR=2.59,95%CI:1.60–4.18,P<0.001),relative afferent pupillary defect(RAPD,OR=1.65,95%CI:1.03–2.64,P=0.039),endophthalmitis(OR=1.75,95%CI:1.01–3.03,P=0.047),retinal detachment(OR=3.32,95%CI:2.02–5.45,P<0.001),and eyelid lacerations(OR=1.94,95%CI:1.13–3.33,P=0.016)associated with OGIs.Vitreous hemorrhage(OR=0.44,95%CI:0.22–0.89,P=0.023)was associated with better outcomes,and female gender appeared protective.CONCLUSION:Poor visual outcomes remain common after OGIs,despite improve visual acuity in many cases.Several clinical and injury-related factors are strongly associated with prognosis.Early recognition of these predictors can support risk stratification and improve trauma care in similar settings.展开更多
BACKGROUND Esophageal cancer is highly malignant and frequently metastasizes to bones.Concomitant depression worsens prognosis;however,its incidence and determinants in this specific population remain poorly defined.A...BACKGROUND Esophageal cancer is highly malignant and frequently metastasizes to bones.Concomitant depression worsens prognosis;however,its incidence and determinants in this specific population remain poorly defined.AIM To determine the incidence of depression and its independent risk factors in patients with esophageal cancer and bone metastasis.METHODS A total of 100 consecutive eligible patients admitted between March 2022 and March 2025 were recruited.Depression was assessed with the Beck Depression Inventory-II;scores>4 defined the depression group(n=42)and scores≤4 the non-depression group(n=58).Demographic,clinical,and laboratory variables were compared between the groups.Multivariate logistic regression was used to identify independent risk factors.RESULTS Depression prevalence was 42.0%(42/100).Univariate analysis demonstrated significant differences in monthly per-capita household income,education level,social support,sleep disorders,and serum high-sensitivity C-reactive protein(all P<0.05);no differences were observed in sex,age,tumor characteristics,or other laboratory indices(all P>0.05).Multivariable analysis revealed the following independent risk factors for depression:Low income[odds ratio(OR)=2.66,95%confidence interval(CI):1.17-6.03],low education(OR=2.46,95%CI:1.08-5.61),low social support(OR=5.10,95%CI:1.81-14.39),sleep disorders(OR=2.79,95%CI:1.23-6.35),and elevated high-sensitivity C-reactive protein(OR=1.31 per unit increase,95%CI:1.18-1.46).CONCLUSION Depression is common among patients with esophageal cancer and bone metastasis.Low socioeconomic status,limited education,insufficient social support,sleep disturbances,and systemic inflammation were independent predictors.Interventions that address these modifiable factors may reduce depression risk in this population.展开更多
AIM:To assess risk factors for epiretinal membranes(ERM)and examine their interactions in a nationally representative U.S.dataset.METHODS:Data from the 2005–2008 National Health and Nutrition Examination Survey(NHANE...AIM:To assess risk factors for epiretinal membranes(ERM)and examine their interactions in a nationally representative U.S.dataset.METHODS:Data from the 2005–2008 National Health and Nutrition Examination Survey(NHANES)were analyzed,a nationally representative U.S.dataset.ERM was identified via retinal imaging based on the presence of cellophane changes.Key predictors included age group,eye surgery history,and refractive error,with additional demographic and health-related covariates.Weighted univariate and multiple logistic regression models were used to assess associations and interaction effects between eye surgery and refractive error.RESULTS:Totally 3925 participants were analyzed.Older age,eye surgery,and refractive errors were significantly associated with ERM.Compared to those under 65y,the odds ratio(OR)for ERM was 3.08 for ages 65–75y(P=0.0014)and 4.76 for ages 75+years(P=0.0069).Eye surgery increased ERM risk(OR=3.48,P=0.0018).Moderate to high hyperopia and myopia were also associated with ERM(OR=2.65 and 1.80,respectively).A significant interaction between refractive error and eye surgery was observed(P<0.0001).Moderate to high myopia was associated with ERM only in those without eye surgery(OR=1.92,P=0.0443).Eye surgery was most strongly associated with ERM in the emmetropic group(OR=3.60,P=0.0027),followed by the moderate to high myopia group(OR=3.01,P=0.0031).CONCLUSION:ERM is significantly associated with aging,eye surgery,and refractive errors.The interaction between eye surgery and refractive error modifies ERM risk and highlights the importance of considering combined effects in clinical risk assessments.These findings may help guide individualized ERM risk assessment that may inform personalized approaches to ERM prevention and management.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
Understanding water chemistry in karst regions is crucial for improving global water resource management and deepening our knowledge of the biogeochemical cycles shaping these sensitive environments.Despite advance-me...Understanding water chemistry in karst regions is crucial for improving global water resource management and deepening our knowledge of the biogeochemical cycles shaping these sensitive environments.Despite advance-ments in karst hydrology,significant gaps remain in long-term trends,underlying processes,and quantitative effects of environmental changes.This is especially true in areas like the Wujiang River(WJ)in China,where human activities such as reservoir construction and land use/cover changes have accelerated hydrochemical changes.We combined recent and historical monitoring data to provide a detailed analysis of the spatial and temporal characteristics,evolution,and controlling factors of major ions in WJ.These findings are important for local water management and contribute to global efforts to manage similar karst systems facing human-induced pressures.Our research shows clear seasonal differences in solute concentrations,with higher levels during the dry season.WJ’s water is rich in calcium,with Ca-HCO_(3) ion pairs being the most common.Reservoir monitor-ing stations show much higher levels of NO_(3)^(−)and SO_(4)^(2−)compared to river-type stations,likely due to longer hydraulic retention time and increased acid deposition.The study confirms the significant role of pH and water temperature in rock weathering processes.Land use/cover changes were identified as the primary drivers of solute variations(46.37%),followed by lithology(13.92%)and temperature(8.35%).Over the past two decades,in-tense carbonate weathering has been observed,especially during wet seasons.Among karstic provinces,Guizhou Province stands out with the highest ion concentrations,indicative of its extensive karst coverage and heightened weathering processes.展开更多
Despite the widespread presence and frequent detection of polycyclic aromatic hydrocarbons(PAHs)in various aspects of life,there is limited research on their exposure levels in pregnant women and cumulative exposure f...Despite the widespread presence and frequent detection of polycyclic aromatic hydrocarbons(PAHs)in various aspects of life,there is limited research on their exposure levels in pregnant women and cumulative exposure from the living environment.This study included 1311 women in late pregnancy from the Zunyi birth cohort and measured the urinary concentrations of 10 hydroxylated PAH metabolites(OH-PAHs).Risk assessment was conducted based on the estimated daily intake to calculate the hazard quotient and hazard index(HI).A linear regression model was used to analyze the relationship between creatinine-adjusted OH-PAHs concentrations and living environment and lifestyle factors,while principal component analysis was applied to trace the sources of PAHs exposure.1-OHPYR was detected in all participants’urine,with naphthalene metabolites having the highest concentrations among creatinine-adjusted PAHs.OH-PAHs concentrations were associated with housing type,room number,cooking frequency,household size,exercise frequency,fuel type,distance from main road,and drinking water source.Pregnant women using traditional fuels and living in bungalows had higher health risks than those using clean energy and living in buildings.Those living within 100 m of a main road had higher HI than those farther away.Coal combustion was identified as the primary source of PAHs exposure.The study emphasizes the importance of reducing PAHs exposure,especially for pregnant women living in polluted environments.It recommends public health interventions such as improving indoor ventilation and providing clean energy to reduce related health risks.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
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
BACKGROUND Neurodevelopmental delays encompass a wide range of conditions that impair cognitive,motor,and social functioning,often increasing the risk of psychiatric comorbidities.Children with these delays frequently...BACKGROUND Neurodevelopmental delays encompass a wide range of conditions that impair cognitive,motor,and social functioning,often increasing the risk of psychiatric comorbidities.Children with these delays frequently present with disorders such as attention-deficit/hyperactivity disorder(ADHD),anxiety,and behavioral disturbances,which can significantly affect development and quality of life.While genetic predisposition has been linked to these comorbidities,growing evidence highlights the role of environmental factors,including prenatal and early-life stressors.However,the interaction between genetic susceptibility and environmental influences remains poorly understood.Identifying specific genetic variants,environmental risks,and their interactions is essential for early detection and targeted interventions.AIM To investigate the combined effects of genetic and environmental factors on psychiatric comorbidities in children with neurodevelopmental delays,elucidate underlying mechanisms,and inform clinical management strategies.METHODS This retrospective cohort study included 80 children with confirmed neurodevelopmental delays and 40 age-and sex-matched typically developing controls.Comprehensive clinical and psychiatric evaluations,genetic testing(chromosomal microarray analysis and targeted next-generation sequencing),and environmental exposure assessments were conducted.Statistical analyses explored associations between genetic variants and psychiatric comorbidities,environmental risk factors,and gene-environment interactions.RESULTS Children with neurodevelopmental delays exhibited significantly higher rates of psychiatric comorbidities(70.0%)compared to controls(15.0%),with ADHD(42.5%),anxiety disorders(28.8%),and behavioral disorders(23.8%)being the most common.Pathogenic genetic variants were identified in specific pathways associated with distinct psychiatric presentations:Glutamatergic signaling variants were linked to anxiety disorders(odds ratio=3.8),dopaminergic system variants to ADHD(odds ratio=4.2),and synaptic function variants to both behavioral and anxiety disorders.Environmental factors,particularly prenatal maternal stress,early childhood adversity,and family dysfunction were strong predictors of psychiatric outcomes(β=0.42).Significant gene-environment interactions were identified,indicating that environmental exposure can moderate the effects of genetic risks on psychiatric outcomes.CONCLUSION Psychiatric comorbidities in children with neurodevelopmental delays are significantly influenced by both genetic and environmental factors,with complex interactions between the two.These findings underscore the need for integrated assessments and targeted interventions addressing both biological and environmental contributors to improve outcomes in this vulnerable population.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
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BACKGROUND Post-transplant tertiary hyperparathyroidism(PT-tHPT)is a well-recognized complication following kidney transplantation,characterized by persistent excessive secretion of parathyroid hormone(PTH)despite improved renal function.It is potentially associated with an increased risk of cardiovascular events,renal osteodystrophy,pathologic fractures,graft loss,and mortality.AIM To evaluate the incidence,risk factors,and outcomes of PT-tHPT amongst kidney transplant recipients.METHODS A total of 887 transplant recipients who underwent transplantation between 2000 and 2020 were evaluated.Univariable and multivariable logistic regression was performed to determine the predictors of tertiary hyperparathyroidism.Graft and recipient outcomes were assessed using multivariable Cox regression.A separate multivariable Cox regression was performed to determine the effect of treatment strategies on outcomes.RESULTS PT-tHPT,defined as elevated PTH(>65 ng/L)and persistent hypercalcemia(>2.60 mmol/L),was diagnosed in 14%of recipients.Risk factors for PT-tHPT included older age[odds ratio(OR)=1.36,P<0.001],Asian ethnicity(OR=0.33,P=0.006),total ischemia time(OR=1.03,P=0.048 per hour),pre-transplant serum calcium(OR=1.38,P<0.001)per decile increase,pre-transplant PTH level(OR=1.31,P<0.001)per decile increase,longer dialysis duration(OR=1.12,P=0.002)per year,history of acute rejection(OR=2.37,P=0.012),and slope of estimated glomerular filtration rate change(OR=0.91,P=0.001).There were a 3.4-fold higher risk of death-censored graft loss and a 1.9-fold greater risk of recipient death with PT-tHPT.The three treatment strategies of conservative management,calcimimetic and parathyroidectomy did not significantly change the graft or patient outcome.CONCLUSION Pretransplant elevated calcium and PTH levels,older age and dialysis duration are associated with PT-tHPT.While PT-tHPT significantly affects graft and recipient survival,the treatment strategies did not affect survival.
文摘BACKGROUND Ischemic stroke is one of the leading global causes of disability and death.Despite advances in modern medical technology that improve acute treatment and rehabilitation measures,post-stroke anxiety and depression(PSD)do not receive sufficient attention.AIM To systematically evaluate risk factors and early identification markers for PSD for more precise screening and intervention strategies in clinical practice.METHODS This retrospective study analyzed clinical data from 112 patients with ischemic stroke admitted between January 2022 and December 2024.Based on assessments using the Hamilton Rating Scale for Anxiety(HAMA)and Hamilton Rating Scale for Depression(HAMD)at 2 weeks(±3 days)post-stroke,patients were classified into the PSD group(HAMA≥7 and/or HAMD≥7)and the non-PSD group(HAMA<7 and HAMD<7).Observation indicators included psychological assessment,demographic and clinical characteristics,stroke-related clinical indicators,neuroimaging assessments,and laboratory biomarkers.Multivariate logistic regression analysis was used to identify independent risk factors for PSD,and receiver operating characteristic curve analysis was used to evaluate the diagnostic value of potential biomarkers.RESULTS Of the 112 patients,46(41.1%)were diagnosed with PSD.Multivariate analysis identified five independent risk factors:Female gender[Odds ratio(OR)=2.32,95%confidence interval(CI):1.56-3.45],history of mental disorders prior to stroke(OR=3.17,95%CI:1.89-5.32),infarct location in the frontal lobe or limbic system(OR=2.86,95%CI:1.73-4.71),stroke severity with National Institutes of Health Stroke Scale≥8 at admission(OR=2.54,95%CI:1.62-3.99),and low social support(Social Support Rating Scale<35,OR=2.18,95%CI:1.42-3.36).Subgroup analysis showed that depression patients more commonly had left hemisphere lesions(68.4%vs 45.2%),while anxiety patients more frequently presented with right hemisphere lesions(59.5%vs 39.5%).The PSD group exhibited larger infarct volumes(8.7 cm^(3) vs 5.3 cm^(3)),more severe white matter hyperintensities,and more pronounced frontal lobe atrophy.Analysis of inflammatory markers showed significantly elevated levels of interleukin-6(7.8 pg/mL vs 4.5 pg/mL)and tumor necrosis factor-alpha(15.6 pg/mL vs 9.8 pg/mL)in the PSD group,while hypothalamicpituitary-adrenal axis function assessment revealed higher cortisol levels(386.5±92.3 nmol/L vs 328.7±75.6 nmol/L)and flattened diurnal rhythm in the PSD group.CONCLUSION PSD is a complex neuropsychiatric consequence of stroke involving disruption of the frontal-limbic circuitry,neuroinflammatory responses,and dysfunction of the hypothalamic-pituitary-adrenal axis.
基金The National Key Research and Development Program of China,No.2023YFC3206601。
文摘Landslides pose a formidable natural hazard across the Qinghai-Tibet Plateau(QTP),endangering both ecosystems and human life.Identifying the driving factors behind landslides and accurately assessing susceptibility are key to mitigating disaster risk.This study integrated multi-source historical landslide data with 15 predictive factors and used several machine learning models—Random Forest(RF),Gradient Boosting Regression Trees(GBRT),Extreme Gradient Boosting(XGBoost),and Categorical Boosting(CatBoost)—to generate susceptibility maps.The Shapley additive explanation(SHAP)method was applied to quantify factor importance and explore their nonlinear effects.The results showed that:(1)CatBoost was the best-performing model(CA=0.938,AUC=0.980)in assessing landslide susceptibility,with altitude emerging as the most significant factor,followed by distance to roads and earthquake sites,precipitation,and slope;(2)the SHAP method revealed critical nonlinear thresholds,demonstrating that historical landslides were concentrated at mid-altitudes(1400-4000 m)and decreased markedly above 4000 m,with a parallel reduction in probability beyond 700 m from roads;and(3)landslide-prone areas,comprising 13%of the QTP,were concentrated in the southeastern and northeastern parts of the plateau.By integrating machine learning and SHAP analysis,this study revealed landslide hazard-prone areas and their driving factors,providing insights to support disaster management strategies and sustainable regional planning.
基金Supported by the Scientific Research Projects of the Health System in Pingshan District,No.2023122.
文摘BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery speed and quality of life.Effective prevention of anxiety and depression in elderly patients has become an urgent problem.AIM To investigate the trajectory of anxiety and depression levels in elderly patients after LIF,and the influencing factors.METHODS Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital.General information and surgery-related indices were recorded,and participants completed measures of psychological status,lumbar spine dysfunction,and quality of life.A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels,and unordered multi-categorical logistic regression was used to analyze the influencing factors.RESULTS Three trajectories of change in anxiety level were identified:Increasing anxiety(n=26,10.88%),decreasing anxiety(n=27,11.30%),and stable anxiety(n=186,77.82%).Likewise,three trajectories of change in depression level were identified:Increasing depression(n=30,12.55%),decreasing depression(n=26,10.88%),and stable depression(n=183,76.57%).Regression analysis showed that having no partner,female sex,elevated Oswestry dysfunction index(ODI)scores,and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels,whereas female sex,postoperative opioid use,and elevated ODI scores all contributed to increased depression levels.CONCLUSION During clinical observation,combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention,quickens recovery,and enhances quality of life.
基金Supported by the National Natural Science Foundation of China,No.82402789Beijing Jishuitan Hospital Youcai Plan,No.KYYC202402+2 种基金Beijing Jishuitan Research Funding,No.HL202402and Beijing Natural Science Foundation,No.L232062No.L222063.
文摘BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different factors.AIM To investigate the key determinants of aseptic loosening,we performed a systematic review and meta-analysis.METHODS A comprehensive search of PubMed,Web of Science,EMBASE,and the Cochrane Library was conducted,encompassing studies from database inception to January 1,2025.Meta-analyses were performed to evaluate factors associated with aseptic loosening following pTHA.Inclusion and exclusion criteria were systematically applied at each stage to ensure methodological transparency and reproducibility.Study quality was assessed using standardized categories.Pooled odds ratio(OR)with corresponding 95%confidence interval were calculated with random-or fixed-effects models to generate reliability estimates,and study heterogeneity was visualized using forest plots.Ten factors,categorized into patient-,surgeon-,and device-related domains,were reviewed and meta-analyzed.Funnel plot analysis demonstrated a relatively symmetrical distribution,suggesting minimal publication bias.RESULTS A meta-analysis of 20 studies(520789 participants)found a pooled prevalence of 1.96%.Significant risk factors for aseptic loosening after pTHA included elevated body mass index(OR=1.116,P<0.001),higher Charlson comorbidity index(OR=1.378,P<0.001),prosthesis-related factors(OR=1.497,P<0.001),and adverse lifestyles(OR=2.198,P=0.037).Protective factors were non-white race(OR=0.445,P<0.001)and favorable genetics(OR=0.723,P<0.001).Male sex increased risk(OR=1.232,P=0.016),while age and anatomy were not significant.Surgical expertise showed a slight protective effect(OR=1.048,P<0.001).A comprehensive understanding of the modifiable and non-modifiable factors contributing to aseptic loosening after pTHA requires consideration of patient-related factors,surgical expertise,and prosthesis characteristics.CONCLUSION The identification of these factors is critical for risk mitigation.High-risk patients should receive targeted counseling regarding individualized profiles.Further studies are warranted to establish clearer causal relationships and identify additional contributing factors.
基金supported by the Natural Science Foundation of China(No.52470105)the Young Taishan Scholars Program of Shandong Province(No.358202103017).
文摘The discharge of micro-polluted water from sources such as agricultural runoff,urban stormwater,and treated effluents presents significant challenges to aquatic ecosystems.Constructed wetlands(CWs)have gained recog-nition as an eco-friendly solution for removing pollutants from various wastewater sources and are increasingly applied for micro-polluted water treatment.By reviewing 78 full-scale CW studies from Web of Science,it is summarized that the ranges of ammonium nitrogen(NH4+-N)concentrations in runoff,wastewater treatment plant effluent and polluted river were 0.1–6.6,0.3–12.3,and 0.2–41.1 mg/L,respectively.The ranges of ni-trate nitrogen concentrations were 0.2–14.2,0–5.7,and 0–2.6 mg/L,respectively.Removal efficiencies of CWs for micro-polluted water varied by CW types.The total nitrogen removal efficiencies for subsurface-flow CWs,free-water surface-flow CWs,and hybrid CWs ranged from 27.4%to 66.5%,16.8%to 89.8%,and 19.4%to 88.2%,respectively.The NH4+-N removal efficiencies ranged from 34.2%to 73.6%,38.4%to 89.4%and 13.5%to 94.2%,respectively.Additionally,other factors influencing contaminant removal efficiency such as hydraulic retention time,vegetation types,redox micro-environment and influent water quality were evaluated.Based on these findings,two strategies for improving the purification performance of CWs were proposed:the selection of incorporating electron donor substrates and the optimization of operation parameters.This paper serves as a synthesis of information to guide future research and full-scale CW applications in micro-polluted water treatment.
文摘AIM:To evaluate the clinical characteristics and risk factors associated with visual prognosis in patients with open globe injuries(OGIs)treated at Vietnam National Eye Hospital.METHODS:A prospective observational study included patients with OGIs treated between June 2023 and June 2024.Data on demographics,injury features,and clinical findings were extracted from medical records.Poor visual outcome was defined as final best-corrected visual acuity(BCVA)worse than 20/400 or no light perception.Multivariable logistic regression was performed to identify independent risk factors.RESULTS:Among 509 patients(636 eyes),the mean age was 35.13y(range 20–51y),and 67.6%were male.After treatment,the proportion of eyes achieving≥20/40 increased from 12.6%to 42.1%,while no light perception decreased from 29.1%to 9.4%.Independent predictors of poor visual outcomes included delayed admission[>4h,odds ratio(OR)=3.33,95%confidence intervals(CI):1.76–6.33,P<0.001],Zone III injury(OR=5.90,95%CI:2.85–12.24,P<0.001),wound length>10 mm(OR=2.59,95%CI:1.60–4.18,P<0.001),relative afferent pupillary defect(RAPD,OR=1.65,95%CI:1.03–2.64,P=0.039),endophthalmitis(OR=1.75,95%CI:1.01–3.03,P=0.047),retinal detachment(OR=3.32,95%CI:2.02–5.45,P<0.001),and eyelid lacerations(OR=1.94,95%CI:1.13–3.33,P=0.016)associated with OGIs.Vitreous hemorrhage(OR=0.44,95%CI:0.22–0.89,P=0.023)was associated with better outcomes,and female gender appeared protective.CONCLUSION:Poor visual outcomes remain common after OGIs,despite improve visual acuity in many cases.Several clinical and injury-related factors are strongly associated with prognosis.Early recognition of these predictors can support risk stratification and improve trauma care in similar settings.
文摘BACKGROUND Esophageal cancer is highly malignant and frequently metastasizes to bones.Concomitant depression worsens prognosis;however,its incidence and determinants in this specific population remain poorly defined.AIM To determine the incidence of depression and its independent risk factors in patients with esophageal cancer and bone metastasis.METHODS A total of 100 consecutive eligible patients admitted between March 2022 and March 2025 were recruited.Depression was assessed with the Beck Depression Inventory-II;scores>4 defined the depression group(n=42)and scores≤4 the non-depression group(n=58).Demographic,clinical,and laboratory variables were compared between the groups.Multivariate logistic regression was used to identify independent risk factors.RESULTS Depression prevalence was 42.0%(42/100).Univariate analysis demonstrated significant differences in monthly per-capita household income,education level,social support,sleep disorders,and serum high-sensitivity C-reactive protein(all P<0.05);no differences were observed in sex,age,tumor characteristics,or other laboratory indices(all P>0.05).Multivariable analysis revealed the following independent risk factors for depression:Low income[odds ratio(OR)=2.66,95%confidence interval(CI):1.17-6.03],low education(OR=2.46,95%CI:1.08-5.61),low social support(OR=5.10,95%CI:1.81-14.39),sleep disorders(OR=2.79,95%CI:1.23-6.35),and elevated high-sensitivity C-reactive protein(OR=1.31 per unit increase,95%CI:1.18-1.46).CONCLUSION Depression is common among patients with esophageal cancer and bone metastasis.Low socioeconomic status,limited education,insufficient social support,sleep disturbances,and systemic inflammation were independent predictors.Interventions that address these modifiable factors may reduce depression risk in this population.
基金Supported by Chengdu Municipal Science and Technology Bureau Key R&D Support Program(No.2023-YF09-00041-SN)。
文摘AIM:To assess risk factors for epiretinal membranes(ERM)and examine their interactions in a nationally representative U.S.dataset.METHODS:Data from the 2005–2008 National Health and Nutrition Examination Survey(NHANES)were analyzed,a nationally representative U.S.dataset.ERM was identified via retinal imaging based on the presence of cellophane changes.Key predictors included age group,eye surgery history,and refractive error,with additional demographic and health-related covariates.Weighted univariate and multiple logistic regression models were used to assess associations and interaction effects between eye surgery and refractive error.RESULTS:Totally 3925 participants were analyzed.Older age,eye surgery,and refractive errors were significantly associated with ERM.Compared to those under 65y,the odds ratio(OR)for ERM was 3.08 for ages 65–75y(P=0.0014)and 4.76 for ages 75+years(P=0.0069).Eye surgery increased ERM risk(OR=3.48,P=0.0018).Moderate to high hyperopia and myopia were also associated with ERM(OR=2.65 and 1.80,respectively).A significant interaction between refractive error and eye surgery was observed(P<0.0001).Moderate to high myopia was associated with ERM only in those without eye surgery(OR=1.92,P=0.0443).Eye surgery was most strongly associated with ERM in the emmetropic group(OR=3.60,P=0.0027),followed by the moderate to high myopia group(OR=3.01,P=0.0031).CONCLUSION:ERM is significantly associated with aging,eye surgery,and refractive errors.The interaction between eye surgery and refractive error modifies ERM risk and highlights the importance of considering combined effects in clinical risk assessments.These findings may help guide individualized ERM risk assessment that may inform personalized approaches to ERM prevention and management.
文摘Understanding crash contributing factors is essential in safety management and improvement. These factors drive investment decisions, policies, regulations, and other safety-related initiatives. This paper analyzes factors that contribute to crash occurrence based on two national datasets in the United States (CISS and NASS-CDS) for the years 2017-2022 and 2010-2015, respectively. Three taxonomies were applied to enhance understanding of the various crash contributing factors. These taxonomies were developed based on previous research and practice and involved different groupings of human factors, vehicle factors, and roadway and environmental factors. Statistics for grouping the different types of factors and statistics for specific factors are provided. The results indicate that human factors are present in over 95% of crashes, roadway and environmental factors are present in over 45% of crashes, and vehicle factors are present in less than 2% of crashes. Regarding factors related to human error and vehicle maintenance, speeding is involved in over 25% of crashes, distraction is involved in over 20% of crashes, alcohol and drugs are involved in over 9% of crashes, and vehicle maintenance is involved in approximately 0.45% of crashes. Approximately 4.4% of crashes involve a driver who “looked but did not see.” Weather is involved in over 13% of crashes. Conclusions: The findings indicate that, consistent with previous research, human factors or human error are present in around 95% of crashes. Infrastructure and environmental factors contribute to about 45% of crashes. Vehicle factors contribute to only 1.67% - 1.71% of crashes. The results from this study could potentially be used to inform future safety management and improvement activities, including policy-making, regulation development, safe systems and systemic safety approaches to safety management, and other engineering, education, emergency response, enforcement, evaluation, and encouragement activities. The findings could also be used in the development of future Driver Assistance Technologies (DAT) systems and in enhancing existing technologies.
基金supported by Guangdong Basic and Applied Basic Research Foundation(Nos.2023A1515110824 and 2025A1515011839)Shenzhen Science and Technology Program(No.RCBS20231211090638066).
文摘Understanding water chemistry in karst regions is crucial for improving global water resource management and deepening our knowledge of the biogeochemical cycles shaping these sensitive environments.Despite advance-ments in karst hydrology,significant gaps remain in long-term trends,underlying processes,and quantitative effects of environmental changes.This is especially true in areas like the Wujiang River(WJ)in China,where human activities such as reservoir construction and land use/cover changes have accelerated hydrochemical changes.We combined recent and historical monitoring data to provide a detailed analysis of the spatial and temporal characteristics,evolution,and controlling factors of major ions in WJ.These findings are important for local water management and contribute to global efforts to manage similar karst systems facing human-induced pressures.Our research shows clear seasonal differences in solute concentrations,with higher levels during the dry season.WJ’s water is rich in calcium,with Ca-HCO_(3) ion pairs being the most common.Reservoir monitor-ing stations show much higher levels of NO_(3)^(−)and SO_(4)^(2−)compared to river-type stations,likely due to longer hydraulic retention time and increased acid deposition.The study confirms the significant role of pH and water temperature in rock weathering processes.Land use/cover changes were identified as the primary drivers of solute variations(46.37%),followed by lithology(13.92%)and temperature(8.35%).Over the past two decades,in-tense carbonate weathering has been observed,especially during wet seasons.Among karstic provinces,Guizhou Province stands out with the highest ion concentrations,indicative of its extensive karst coverage and heightened weathering processes.
基金supported by the National Key R&D Program of China(Nos.2018YFC1004300 and 2018YFC1004302)the Science&Technology Program of Guizhou Province(Nos.QKHHBZ[2020]3002,QKHPTRC-GCC[2022]039-1 and QKHPTRCCXTD[2022]014)the Scientific Research Program of Guizhou Provincial Department of Education(No.QJJ[2023]019).
文摘Despite the widespread presence and frequent detection of polycyclic aromatic hydrocarbons(PAHs)in various aspects of life,there is limited research on their exposure levels in pregnant women and cumulative exposure from the living environment.This study included 1311 women in late pregnancy from the Zunyi birth cohort and measured the urinary concentrations of 10 hydroxylated PAH metabolites(OH-PAHs).Risk assessment was conducted based on the estimated daily intake to calculate the hazard quotient and hazard index(HI).A linear regression model was used to analyze the relationship between creatinine-adjusted OH-PAHs concentrations and living environment and lifestyle factors,while principal component analysis was applied to trace the sources of PAHs exposure.1-OHPYR was detected in all participants’urine,with naphthalene metabolites having the highest concentrations among creatinine-adjusted PAHs.OH-PAHs concentrations were associated with housing type,room number,cooking frequency,household size,exercise frequency,fuel type,distance from main road,and drinking water source.Pregnant women using traditional fuels and living in bungalows had higher health risks than those using clean energy and living in buildings.Those living within 100 m of a main road had higher HI than those farther away.Coal combustion was identified as the primary source of PAHs exposure.The study emphasizes the importance of reducing PAHs exposure,especially for pregnant women living in polluted environments.It recommends public health interventions such as improving indoor ventilation and providing clean energy to reduce related health risks.
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.
文摘BACKGROUND Neurodevelopmental delays encompass a wide range of conditions that impair cognitive,motor,and social functioning,often increasing the risk of psychiatric comorbidities.Children with these delays frequently present with disorders such as attention-deficit/hyperactivity disorder(ADHD),anxiety,and behavioral disturbances,which can significantly affect development and quality of life.While genetic predisposition has been linked to these comorbidities,growing evidence highlights the role of environmental factors,including prenatal and early-life stressors.However,the interaction between genetic susceptibility and environmental influences remains poorly understood.Identifying specific genetic variants,environmental risks,and their interactions is essential for early detection and targeted interventions.AIM To investigate the combined effects of genetic and environmental factors on psychiatric comorbidities in children with neurodevelopmental delays,elucidate underlying mechanisms,and inform clinical management strategies.METHODS This retrospective cohort study included 80 children with confirmed neurodevelopmental delays and 40 age-and sex-matched typically developing controls.Comprehensive clinical and psychiatric evaluations,genetic testing(chromosomal microarray analysis and targeted next-generation sequencing),and environmental exposure assessments were conducted.Statistical analyses explored associations between genetic variants and psychiatric comorbidities,environmental risk factors,and gene-environment interactions.RESULTS Children with neurodevelopmental delays exhibited significantly higher rates of psychiatric comorbidities(70.0%)compared to controls(15.0%),with ADHD(42.5%),anxiety disorders(28.8%),and behavioral disorders(23.8%)being the most common.Pathogenic genetic variants were identified in specific pathways associated with distinct psychiatric presentations:Glutamatergic signaling variants were linked to anxiety disorders(odds ratio=3.8),dopaminergic system variants to ADHD(odds ratio=4.2),and synaptic function variants to both behavioral and anxiety disorders.Environmental factors,particularly prenatal maternal stress,early childhood adversity,and family dysfunction were strong predictors of psychiatric outcomes(β=0.42).Significant gene-environment interactions were identified,indicating that environmental exposure can moderate the effects of genetic risks on psychiatric outcomes.CONCLUSION Psychiatric comorbidities in children with neurodevelopmental delays are significantly influenced by both genetic and environmental factors,with complex interactions between the two.These findings underscore the need for integrated assessments and targeted interventions addressing both biological and environmental contributors to improve outcomes in this vulnerable population.
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.
