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
Moving from the most recent results on Foxg1 biology,we first summarize the available information on some special pleiotropic effectors of neurodevelopmental interest,involved in controlling both transcription and pos...Moving from the most recent results on Foxg1 biology,we first summarize the available information on some special pleiotropic effectors of neurodevelopmental interest,involved in controlling both transcription and post-transcriptional steps of gene expression.Then,after further analysis of the literature,we report evidence that,not strictly limited to neurodevelopmental effectors,such pleiotropy also applies to other transcription factors,involved in physiology and homeostasis.Furthermore,through the systematic analysis of a major public protein-protein interaction database,we gather strong evidence that the involvement of“canonical”transcription factors in post-transcriptional control of gene expression could be a pervasive phenomenon,characterizing hundreds of effectors.Finally,we discuss the biological significance of these findings and propose three evolutionary mechanisms that may have contributed to such an unexpected scenario.展开更多
Objective:To investigate the related factors of motility after total hip arthroplasty(THA).Methods:The convenience sampling method was used to include 213 patients receiving THA in our hospital from June 2020 to June ...Objective:To investigate the related factors of motility after total hip arthroplasty(THA).Methods:The convenience sampling method was used to include 213 patients receiving THA in our hospital from June 2020 to June 2023.They were divided into 2 groups according to the occurrence of kinesiophobia after THA.The demographic data of the 2 groups were analyzed by single-factor analysis.The factors with statistically significant differences were analyzed by binary logistic regression as independent variables.Finally,Spearman analysis was used to analyze the relationship between risk factors and the degree of kinesiophobia.Results:Among 213 THA patients,38 patients were diagnosed with kinetophobia,and the incidence of kinetophobia was 17.84%.visual analogue scale(VAS)and pain duration before operation were higher in patients with kinetophobia than in patients without kinetophobia.The scores of education level,self-efficacy,and social support were significantly lower than those of the non-phobia group,with statistical significance(P<0.05).Logistic regression analysis showed that VAS was a risk factor for kinetophobia after THA.Education level and self-efficacy were protective factors to reduce the occurrence of kinetophobia after THA(P<0.05).Spearman correlation analysis showed that the degree of pain(r=0.697,P<0.001)was positively correlated with the degree of kinetophobia,while the degree of education(r=-0.647,P<0.001)and self-efficacy(r=-0.756,P<0.001)were negatively correlated with the degree of kinetophobia.Conclusions:The degree of pain is a risk factor of kinesiophobia after THA,and it is positively correlated with the degree.Educational level and self-efficacy were protective factors to reduce the incidence of kinesiophobia and were negatively correlated with the degree of kinesiophobia.展开更多
Objective Frailty is becoming increasingly common among aging adults.Frailty transitionis shaped by biological,social,psychological,and environmental factors.This study investigated combined effects of protective fact...Objective Frailty is becoming increasingly common among aging adults.Frailty transitionis shaped by biological,social,psychological,and environmental factors.This study investigated combined effects of protective factors on frailty transition by constructing a Protection Index(PI)to guide targeted interventions.Methods Data were extracted from the 4th Sample Survey of the Aged Population in Urban and Rural China,including baseline(2017)and follow-up(2019)surveys.Frailty was assessed using the Frailty Index(FI),whereas the PI measured protective factors.Frailty transitions over 2 years were analyzed prospectively.Pearson’s correlation examined the relationship between FI and PI,and logistic regression assessed the effects of PI on frailty transitions.Results This study included 9,093 older adults.FI values increased with age and were higher in women,whereas PI values decreased with age and were higher in men.Over 2 years,56.2%of the participants showed a stable frailty status,14.2%improved,and 29.6%worsened.Negative transitions were more common than positive transitions,with transitions occurring most frequently between adjacent states.The PI was moderately negatively correlated with the FI(r=−0.349,P<0.001).A higher PI was associated with a lower risk of negative transitions among robust and prefrail individuals(OR=0.989,0.981,both P<0.05),but showed no significant effect among those with existing frailty.Conclusion Negative frailty transitions were more common with advancing age.Enhancing PI may help prevent negative frailty transitions among robust and pre-frail older adults,underscoring the value of early interventions.展开更多
Environment serves as the pivotal medium to produce fermented food,with fluctuations in environmental factors exerting a profound impact on the modulation of fermentation microbial communities.Such shifts are crucial ...Environment serves as the pivotal medium to produce fermented food,with fluctuations in environmental factors exerting a profound impact on the modulation of fermentation microbial communities.Such shifts are crucial for the distinctiveness of fermented food flavor and the variability in quality.Chinese liquor(Baijiu)is one of the typical representatives of spontaneous fermented food.In this review,the multifaceted relationship between regional environmental attributes and the fermentation dynamics of Baijiu was examined,with a spotlight on the strong-flavor,sauce-flavor,and light-flavor varieties.It reveals the influence of regional environmental factors and brewing environmental factors on microbial function and metabolism,which results in the formation of unique flavor characteristics of Baijiu.The 9 main factors affecting the microecology of Baijiu fermentation were further explored,including environmental sensitivity,microbial interactions,biogeographic patterns,and key abiotic factors such as temperature and humidity.Environmental factor management is crucial for controlling microbial community in fermentation.Intelligent detection of the fermentation system is combined with artificial intelligence to realize the digitalization of Baijiu fermentation,with a view to further studying the environmental mechanism or quantitative control relationship of natural fermentation,improving the environmental stability of natural fermentation,and promoting the mechanization and intelligence of fermentation production.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
Major chemical ionic components in water serve as indicators of natural factors in the areas traversed by water bodies,and are thus widely used to elucidate key hydrogeochemical processes,including rock weathering,aqu...Major chemical ionic components in water serve as indicators of natural factors in the areas traversed by water bodies,and are thus widely used to elucidate key hydrogeochemical processes,including rock weathering,aquatic evaporation-crystallization,and the input of precipitation-derived materials into river basins.A total of 208 water samples were collected between August 2021 and August 2022 to investigate the hydrochemical characteristics and their influencing factors of the surface water and the groundwater in the Mingyong River Basin.To systematically analyze the data,we combined hydrogeochemical and statistical methods:descriptive statistics characterized ion concentration and physicochemical parameter distributions;Piper trilinear diagrams classified hydrochemical types;Pearson correlation analysis assessed ion-ion and ionTDS dependencies;Gibbs diagrams and ion ratio analysis identified solute sources;and the absolute principal component score-multiple linear regression(APCS-MLR)model quantified the contribution rates of different influencing factors.The results revealed that the dominant cations in the surface water and groundwater are Ca^(2+)and Mg^(2+),while the dominant anions are HCO_(3)^(-)and SO_(4)^(2-).The groundwater exhibits an extended residence time within rock strata,facilitating prolonged interaction with soluble minerals and intensifying the water-rock reaction process,thereby resulting in higher levels of electrical conductivity(EC),pH,and total dissolved solids(TDS)than those in the surface water.Secondly,the parameters of the surface water and groundwater indicate positive correlation.The weathering of rocks constitutes the primary solute source in the water of the basin.The hydrochemical composition of the basin water is primarily influenced by both carbonate and silicate rocks,with a minor contribution from evaporite rocks.The water bodies in the basin are affected by anthropogenic activities.The surface water is influenced by four sources,namely lixiviation-enrich,human activities,geological environmental,and unknown sources.The groundwater is influenced by five sources,namely lixiviation-enrich,primary geological,human activities,geological environmental,and unknown sources.展开更多
Objectives This study aimed to explore the lagged and cumulative effects of risk factors on disability in older adults using distributed lag non-linear models(DLNMs).Methods We utilized data from the China Health and ...Objectives This study aimed to explore the lagged and cumulative effects of risk factors on disability in older adults using distributed lag non-linear models(DLNMs).Methods We utilized data from the China Health and Retirement Longitudinal Study(CHARLS).After feature selection via Elastic Net Regularization,we applied DLNMs to evaluate the lagged effects of risk factors.Disability was defined as the presence of any difficulties in basic activities of daily living(BADL).The cumulative relative risk(CRR)was calculated by summing the lag-specific risk estimates,representing the cumulative disability risk over the specified lag period.Effect modifications and sensitivity analyses were also performed.Results This study included a total of 2,318 participants.Early-phase lag factors,such as the difficulty in stooping(CRR=3.58;95%CI:2.31-5.55;P<0.001)and walking(CRR=2.77;95%CI:1.39-5.55;P<0.001),exerted the strongest effects immediately upon occurrence.Mid-phase lag factors,such as arthritis(CRR=1.51;95%CI:1.10-2.06;P=0.001),showed a resurgence in disability risk within 2-3 years.Late-phase lag factors,including depressive symptoms(CRR=2.38;95%CI:1.30-4.35;P<0.001)and elevated systolic blood pressure(CRR=1.64;95%CI:1.06-2.79;P=0.02),exhibited significant long-term cumulative risks.Conversely,grip strength(CRR=0.80;95%CI:0.54-0.95;P=0.02)and social participation(CRR=0.89;95%CI:0.73-0.99;P=0.04)were significant protective factors.Conclusions The findings underscore the importance of tailored interventions that account for various lag characteristics of different factors to effectively mitigate disability risk.Future studies should explore the underlying biological and sociological mechanisms of these lagged effects,identify intervention strategies that target risk factors with different lagged patterns,and evaluate their effectiveness.展开更多
This paper provides a systematic review of the histochemical localization,content characteristics,and influencing factors of saponins in Pseudostellaria heterophylla based on an extensive literature survey.It provides...This paper provides a systematic review of the histochemical localization,content characteristics,and influencing factors of saponins in Pseudostellaria heterophylla based on an extensive literature survey.It provides an in-depth analysis and summary of the effects of biological factors,environmental conditions,agronomic practices,processing methods,and continuous cropping obstacles on the synthesis of P.heterophylla saponins,as well as their underlying mechanisms.Based on identified gaps in the current literature,future research directions and prospects are proposed.The findings of this review offer valuable insights for advancing the understanding of the saponin biosynthesis mechanisms in P.heterophylla and for enhancing its quality.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
Iron isotopes,represented byδ^(56)Fe,serve as valuable tools for constraining the surface iron processes and as potent tracers for studying the biogeochemical cycle of iron.Nevertheless,our comprehension of iron isot...Iron isotopes,represented byδ^(56)Fe,serve as valuable tools for constraining the surface iron processes and as potent tracers for studying the biogeochemical cycle of iron.Nevertheless,our comprehension of iron isotopes in the land surface processes of the Tibetan Plateau(TP)remains limited.In this study,we present the results of iron isotopic composition(δ^(56)Fe)in the surface soils of the TP,encompassing both glacial and non-glacial regions characterized by rugged and flat topographies.Our findings reveal that soilδ^(56)Fe values ranged from-0.01‰±0.05‰to 0.14‰±0.01‰,with the highest values observed in eastern locations(0.14‰)and the lowest appeared in the northeast(-0.1‰).On a global scale,theδ^(56)Fe values observed in Tibetan soils exhibited relatively small variability compared to reservoirs marked by significant iron isotope fractionation.By contrast,the range of TP soils measured here was slightly larger than that of the Chinese Loess.Furthermore,we discerned noticeable spatial variations inδ^(56)Fe across the large-scale region of TP,indicating a gradual increase trend from the northeast to the south and from the west to the east.These regional disparities inδ^(56)Fe likely arise from a combination of constraining factors,including differences in mineralogy,lithological variations,organic matter content,and variations in chemical weathering intensity.This study is pivotal in advancing our understanding of land surface iron isotope dynamics and its role in the biogeochemical cycle within the TP region.展开更多
Objectives:Uretero-enteric strictures are feared complications following cystectomy.Despite surgical advancements,particularly the rise of robot-assisted approaches,the risk factors associated with these strictures re...Objectives:Uretero-enteric strictures are feared complications following cystectomy.Despite surgical advancements,particularly the rise of robot-assisted approaches,the risk factors associated with these strictures remain poorly defined.This study aimed to identify the risk factors associated with uretero-enteric anastomotic strictures after cystectomy,according to the surgical approach and type of urinary diversion(extracorporeal vs.intracorporeal).Methods:We conducted a single-center retrospective study including 340 patients who underwent cystectomy between 2016 and 2024 at Tours University Hospital.Clinical,biological,perioperative,and postoperative data were analyzed.The occurrence of a uretero-ileal anastomotic stricture was defined radiologically by a uretero-hydronephrosis≥20 mm.We constructed and analyzed a learning curve for robotic surgery with intracorporeal urinary diversion.Results:Strictures occurred in 60 patients(17.6%).On multivariable analysis,reduced preoperative glomerular filtration rate(odds ratio[OR]=1.45 per 10 mL/min decrease,95%CI[1.12-1.87],p=0.004),elevated creatinine(OR=1.30 per 10μmol/L increase,95%CI[1.05-1.61],p=0.018),prior myocardial infarction(OR=2.25,95%CI[1.10-4.62],p=0.027),and postoperative urinary tract infection(OR=3.10,95%CI[1.65-5.82],p<0.001)were independent predictors.Most strictures were left-sided.Intracorporeal robotic diversion had a higher,though non-significant,stricture rate(21.5%vs.15.2%,OR=1.52,p=0.12).Stricture rates fell markedly after 20 robotic cases per surgeon(23.8%vs.12.1%).Conclusion:Uretero-enteric strictures are multifactorial,strongly influenced by baseline renal function,cardiovascular comorbidity,and postoperative infection.Robotic intracorporeal diversion shows a learning curve effect,underlining the importance of surgical expertise and infection prevention in reducing risk.展开更多
Tuberculosis(TB),one of the oldest infectious diseases caused by Mycobacterium tuberculosis,poses a considerable challenge to global public health.There are approximately 10 million new TB cases worldwide annually,and...Tuberculosis(TB),one of the oldest infectious diseases caused by Mycobacterium tuberculosis,poses a considerable challenge to global public health.There are approximately 10 million new TB cases worldwide annually,and TB claims the lives of nearly 3 million people each year,making it one of the leading causes of death from a single infectious disease[1].China ranks third globally in terms of TB burden,with approximately 733,000 TB cases reported in 2023[2].Based on the ecological model of health determinants developed by Whitehead and Dahlgren,health determinants can be classified into direct causes.展开更多
This paper proposes a robust control-oriented identification method for errors-in-variables(EIV)systems in output feedbacks using frequency-response(FR)experimental data.An important relation between such a closed-loo...This paper proposes a robust control-oriented identification method for errors-in-variables(EIV)systems in output feedbacks using frequency-response(FR)experimental data.An important relation between such a closed-loop EIV system and its coprime factor(CF)uncertainty description is first derived,based on which the FR measurements suitable for plant CF identification are able to be generated.Different factorizations of a given controller in the closed-loop system can be made best use to adjust right coprime factors(RCFs)of the plant so as to realize an improvement on the signal-to-noise ratio of identification experimental data.Subsequently,a nominal RCF model is estimated by linear matrix inequalities from the applicable FR measurements and its associated worst-case errors are quantified from a priori and a posteriori information on the underlying system.A resulting RCF perturbation model set can then be described by the nominal RCF model and its worst-case error bounds.Such a model set capable of being stabilized by the given controller is ready for its robust stabilizing controller redesign and robust performance analysis.Finally,a numerical simulation is given to show the efficacy of the proposed identification method.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supported by SISSA(intramural funding to AM)International FOXG1 Research Foundation(Grant to AM)+1 种基金Italian Ministery of University and Research(Grant PRIN222022M95RC7 to AM)Fondazione Telethon(Grant GMR22T2018 to AM).
文摘Moving from the most recent results on Foxg1 biology,we first summarize the available information on some special pleiotropic effectors of neurodevelopmental interest,involved in controlling both transcription and post-transcriptional steps of gene expression.Then,after further analysis of the literature,we report evidence that,not strictly limited to neurodevelopmental effectors,such pleiotropy also applies to other transcription factors,involved in physiology and homeostasis.Furthermore,through the systematic analysis of a major public protein-protein interaction database,we gather strong evidence that the involvement of“canonical”transcription factors in post-transcriptional control of gene expression could be a pervasive phenomenon,characterizing hundreds of effectors.Finally,we discuss the biological significance of these findings and propose three evolutionary mechanisms that may have contributed to such an unexpected scenario.
基金supported by the Henan Provincial Medical Science and Technology Research Program,grant funded by the Henan Provincial Health Commission(No.LHGJ 20200888)。
文摘Objective:To investigate the related factors of motility after total hip arthroplasty(THA).Methods:The convenience sampling method was used to include 213 patients receiving THA in our hospital from June 2020 to June 2023.They were divided into 2 groups according to the occurrence of kinesiophobia after THA.The demographic data of the 2 groups were analyzed by single-factor analysis.The factors with statistically significant differences were analyzed by binary logistic regression as independent variables.Finally,Spearman analysis was used to analyze the relationship between risk factors and the degree of kinesiophobia.Results:Among 213 THA patients,38 patients were diagnosed with kinetophobia,and the incidence of kinetophobia was 17.84%.visual analogue scale(VAS)and pain duration before operation were higher in patients with kinetophobia than in patients without kinetophobia.The scores of education level,self-efficacy,and social support were significantly lower than those of the non-phobia group,with statistical significance(P<0.05).Logistic regression analysis showed that VAS was a risk factor for kinetophobia after THA.Education level and self-efficacy were protective factors to reduce the occurrence of kinetophobia after THA(P<0.05).Spearman correlation analysis showed that the degree of pain(r=0.697,P<0.001)was positively correlated with the degree of kinetophobia,while the degree of education(r=-0.647,P<0.001)and self-efficacy(r=-0.756,P<0.001)were negatively correlated with the degree of kinetophobia.Conclusions:The degree of pain is a risk factor of kinesiophobia after THA,and it is positively correlated with the degree.Educational level and self-efficacy were protective factors to reduce the incidence of kinesiophobia and were negatively correlated with the degree of kinesiophobia.
基金supported by grants from the National Key R&D Program of China[Grant Nos.2020YFC2003000 and 2020YFC2003001]the National High Level Hospital Clinical Research Funding(BJ-2023-074 and BJ-2023-018)+1 种基金Beijing Municipal Science&Technology Commission“AI+Health Collaborative Innovation Cultivation”Project(Z221100003522015)the Non-Profit Central Research Institute Fund of the Chinese Academy of Medical Sciences(2021-JKCS-024).
文摘Objective Frailty is becoming increasingly common among aging adults.Frailty transitionis shaped by biological,social,psychological,and environmental factors.This study investigated combined effects of protective factors on frailty transition by constructing a Protection Index(PI)to guide targeted interventions.Methods Data were extracted from the 4th Sample Survey of the Aged Population in Urban and Rural China,including baseline(2017)and follow-up(2019)surveys.Frailty was assessed using the Frailty Index(FI),whereas the PI measured protective factors.Frailty transitions over 2 years were analyzed prospectively.Pearson’s correlation examined the relationship between FI and PI,and logistic regression assessed the effects of PI on frailty transitions.Results This study included 9,093 older adults.FI values increased with age and were higher in women,whereas PI values decreased with age and were higher in men.Over 2 years,56.2%of the participants showed a stable frailty status,14.2%improved,and 29.6%worsened.Negative transitions were more common than positive transitions,with transitions occurring most frequently between adjacent states.The PI was moderately negatively correlated with the FI(r=−0.349,P<0.001).A higher PI was associated with a lower risk of negative transitions among robust and prefrail individuals(OR=0.989,0.981,both P<0.05),but showed no significant effect among those with existing frailty.Conclusion Negative frailty transitions were more common with advancing age.Enhancing PI may help prevent negative frailty transitions among robust and pre-frail older adults,underscoring the value of early interventions.
基金financially supported by the National Natural Science Foundation of China(22138004)National Treasure Ecological Research Synergetic Innovation Center.
文摘Environment serves as the pivotal medium to produce fermented food,with fluctuations in environmental factors exerting a profound impact on the modulation of fermentation microbial communities.Such shifts are crucial for the distinctiveness of fermented food flavor and the variability in quality.Chinese liquor(Baijiu)is one of the typical representatives of spontaneous fermented food.In this review,the multifaceted relationship between regional environmental attributes and the fermentation dynamics of Baijiu was examined,with a spotlight on the strong-flavor,sauce-flavor,and light-flavor varieties.It reveals the influence of regional environmental factors and brewing environmental factors on microbial function and metabolism,which results in the formation of unique flavor characteristics of Baijiu.The 9 main factors affecting the microecology of Baijiu fermentation were further explored,including environmental sensitivity,microbial interactions,biogeographic patterns,and key abiotic factors such as temperature and humidity.Environmental factor management is crucial for controlling microbial community in fermentation.Intelligent detection of the fermentation system is combined with artificial intelligence to realize the digitalization of Baijiu fermentation,with a view to further studying the environmental mechanism or quantitative control relationship of natural fermentation,improving the environmental stability of natural fermentation,and promoting the mechanization and intelligence of fermentation production.
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funded by the National Natural Science Foundation of China(No.42061012)the Open Project of Yunnan Province’s First Class Discipline of Soil and Water Conservation and Desertification Control(SBK20240019)。
文摘Major chemical ionic components in water serve as indicators of natural factors in the areas traversed by water bodies,and are thus widely used to elucidate key hydrogeochemical processes,including rock weathering,aquatic evaporation-crystallization,and the input of precipitation-derived materials into river basins.A total of 208 water samples were collected between August 2021 and August 2022 to investigate the hydrochemical characteristics and their influencing factors of the surface water and the groundwater in the Mingyong River Basin.To systematically analyze the data,we combined hydrogeochemical and statistical methods:descriptive statistics characterized ion concentration and physicochemical parameter distributions;Piper trilinear diagrams classified hydrochemical types;Pearson correlation analysis assessed ion-ion and ionTDS dependencies;Gibbs diagrams and ion ratio analysis identified solute sources;and the absolute principal component score-multiple linear regression(APCS-MLR)model quantified the contribution rates of different influencing factors.The results revealed that the dominant cations in the surface water and groundwater are Ca^(2+)and Mg^(2+),while the dominant anions are HCO_(3)^(-)and SO_(4)^(2-).The groundwater exhibits an extended residence time within rock strata,facilitating prolonged interaction with soluble minerals and intensifying the water-rock reaction process,thereby resulting in higher levels of electrical conductivity(EC),pH,and total dissolved solids(TDS)than those in the surface water.Secondly,the parameters of the surface water and groundwater indicate positive correlation.The weathering of rocks constitutes the primary solute source in the water of the basin.The hydrochemical composition of the basin water is primarily influenced by both carbonate and silicate rocks,with a minor contribution from evaporite rocks.The water bodies in the basin are affected by anthropogenic activities.The surface water is influenced by four sources,namely lixiviation-enrich,human activities,geological environmental,and unknown sources.The groundwater is influenced by five sources,namely lixiviation-enrich,primary geological,human activities,geological environmental,and unknown sources.
基金supported by ScientificResearch Fund of National Health Commission of the People’s Republic of China-Major Science and Technology Program for Medicine and Health in Zhejiang Province(WKJ-ZJ-2406).
文摘Objectives This study aimed to explore the lagged and cumulative effects of risk factors on disability in older adults using distributed lag non-linear models(DLNMs).Methods We utilized data from the China Health and Retirement Longitudinal Study(CHARLS).After feature selection via Elastic Net Regularization,we applied DLNMs to evaluate the lagged effects of risk factors.Disability was defined as the presence of any difficulties in basic activities of daily living(BADL).The cumulative relative risk(CRR)was calculated by summing the lag-specific risk estimates,representing the cumulative disability risk over the specified lag period.Effect modifications and sensitivity analyses were also performed.Results This study included a total of 2,318 participants.Early-phase lag factors,such as the difficulty in stooping(CRR=3.58;95%CI:2.31-5.55;P<0.001)and walking(CRR=2.77;95%CI:1.39-5.55;P<0.001),exerted the strongest effects immediately upon occurrence.Mid-phase lag factors,such as arthritis(CRR=1.51;95%CI:1.10-2.06;P=0.001),showed a resurgence in disability risk within 2-3 years.Late-phase lag factors,including depressive symptoms(CRR=2.38;95%CI:1.30-4.35;P<0.001)and elevated systolic blood pressure(CRR=1.64;95%CI:1.06-2.79;P=0.02),exhibited significant long-term cumulative risks.Conversely,grip strength(CRR=0.80;95%CI:0.54-0.95;P=0.02)and social participation(CRR=0.89;95%CI:0.73-0.99;P=0.04)were significant protective factors.Conclusions The findings underscore the importance of tailored interventions that account for various lag characteristics of different factors to effectively mitigate disability risk.Future studies should explore the underlying biological and sociological mechanisms of these lagged effects,identify intervention strategies that target risk factors with different lagged patterns,and evaluate their effectiveness.
基金Supported by Open Fund Project of the Engineering Technology Research Center of Characteristic Medicinal Plants of Fujian(PP202003).
文摘This paper provides a systematic review of the histochemical localization,content characteristics,and influencing factors of saponins in Pseudostellaria heterophylla based on an extensive literature survey.It provides an in-depth analysis and summary of the effects of biological factors,environmental conditions,agronomic practices,processing methods,and continuous cropping obstacles on the synthesis of P.heterophylla saponins,as well as their underlying mechanisms.Based on identified gaps in the current literature,future research directions and prospects are proposed.The findings of this review offer valuable insights for advancing the understanding of the saponin biosynthesis mechanisms in P.heterophylla and for enhancing its quality.
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+1 种基金Beijing Jishuitan Research Funding,No.HL202402and Beijing Natural Science Foundation,No.L232062,No.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.
基金supported by the National Natural Science Foundation of China(Nos.42201152,42371139)the Gansu Province Natural Science Foundation Key Project(No.23JRRA858)+2 种基金the Fundamental Research Funds for the Central Universities,China University of Geosciences(Wuhan)(No.CUG240629)the“CUG Scholar”Scientific Research Funds at China University of Geosciences(Wuhan)(No.2023092)EJRP is supported by the German Research Foundation(DFG)through the Heisenberg Programme“Multiscale Simulation of Earth Surface Processes”。
文摘Iron isotopes,represented byδ^(56)Fe,serve as valuable tools for constraining the surface iron processes and as potent tracers for studying the biogeochemical cycle of iron.Nevertheless,our comprehension of iron isotopes in the land surface processes of the Tibetan Plateau(TP)remains limited.In this study,we present the results of iron isotopic composition(δ^(56)Fe)in the surface soils of the TP,encompassing both glacial and non-glacial regions characterized by rugged and flat topographies.Our findings reveal that soilδ^(56)Fe values ranged from-0.01‰±0.05‰to 0.14‰±0.01‰,with the highest values observed in eastern locations(0.14‰)and the lowest appeared in the northeast(-0.1‰).On a global scale,theδ^(56)Fe values observed in Tibetan soils exhibited relatively small variability compared to reservoirs marked by significant iron isotope fractionation.By contrast,the range of TP soils measured here was slightly larger than that of the Chinese Loess.Furthermore,we discerned noticeable spatial variations inδ^(56)Fe across the large-scale region of TP,indicating a gradual increase trend from the northeast to the south and from the west to the east.These regional disparities inδ^(56)Fe likely arise from a combination of constraining factors,including differences in mineralogy,lithological variations,organic matter content,and variations in chemical weathering intensity.This study is pivotal in advancing our understanding of land surface iron isotope dynamics and its role in the biogeochemical cycle within the TP region.
文摘Objectives:Uretero-enteric strictures are feared complications following cystectomy.Despite surgical advancements,particularly the rise of robot-assisted approaches,the risk factors associated with these strictures remain poorly defined.This study aimed to identify the risk factors associated with uretero-enteric anastomotic strictures after cystectomy,according to the surgical approach and type of urinary diversion(extracorporeal vs.intracorporeal).Methods:We conducted a single-center retrospective study including 340 patients who underwent cystectomy between 2016 and 2024 at Tours University Hospital.Clinical,biological,perioperative,and postoperative data were analyzed.The occurrence of a uretero-ileal anastomotic stricture was defined radiologically by a uretero-hydronephrosis≥20 mm.We constructed and analyzed a learning curve for robotic surgery with intracorporeal urinary diversion.Results:Strictures occurred in 60 patients(17.6%).On multivariable analysis,reduced preoperative glomerular filtration rate(odds ratio[OR]=1.45 per 10 mL/min decrease,95%CI[1.12-1.87],p=0.004),elevated creatinine(OR=1.30 per 10μmol/L increase,95%CI[1.05-1.61],p=0.018),prior myocardial infarction(OR=2.25,95%CI[1.10-4.62],p=0.027),and postoperative urinary tract infection(OR=3.10,95%CI[1.65-5.82],p<0.001)were independent predictors.Most strictures were left-sided.Intracorporeal robotic diversion had a higher,though non-significant,stricture rate(21.5%vs.15.2%,OR=1.52,p=0.12).Stricture rates fell markedly after 20 robotic cases per surgeon(23.8%vs.12.1%).Conclusion:Uretero-enteric strictures are multifactorial,strongly influenced by baseline renal function,cardiovascular comorbidity,and postoperative infection.Robotic intracorporeal diversion shows a learning curve effect,underlining the importance of surgical expertise and infection prevention in reducing risk.
基金supported by the National Natural Science Foundation of China(82574173,82003516)Jiangsu Provincial Natural Science Foundation(BK20251958)+2 种基金Jiangsu Provincial Medical Key Discipline(ZDXK202250)Top Talent Awards Project Fund(RDF-TP-0023,RDF-TP-0030)Postgraduate Research Fund(PGRS2112022)at Xi'an Jiaotong-Liverpool University.
文摘Tuberculosis(TB),one of the oldest infectious diseases caused by Mycobacterium tuberculosis,poses a considerable challenge to global public health.There are approximately 10 million new TB cases worldwide annually,and TB claims the lives of nearly 3 million people each year,making it one of the leading causes of death from a single infectious disease[1].China ranks third globally in terms of TB burden,with approximately 733,000 TB cases reported in 2023[2].Based on the ecological model of health determinants developed by Whitehead and Dahlgren,health determinants can be classified into direct causes.
文摘This paper proposes a robust control-oriented identification method for errors-in-variables(EIV)systems in output feedbacks using frequency-response(FR)experimental data.An important relation between such a closed-loop EIV system and its coprime factor(CF)uncertainty description is first derived,based on which the FR measurements suitable for plant CF identification are able to be generated.Different factorizations of a given controller in the closed-loop system can be made best use to adjust right coprime factors(RCFs)of the plant so as to realize an improvement on the signal-to-noise ratio of identification experimental data.Subsequently,a nominal RCF model is estimated by linear matrix inequalities from the applicable FR measurements and its associated worst-case errors are quantified from a priori and a posteriori information on the underlying system.A resulting RCF perturbation model set can then be described by the nominal RCF model and its worst-case error bounds.Such a model set capable of being stabilized by the given controller is ready for its robust stabilizing controller redesign and robust performance analysis.Finally,a numerical simulation is given to show the efficacy of the proposed identification method.
