BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therape...BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therapeutic modality to improve healing outcomes in DFU management.AIM To evaluate the efficacy of UAWD in treating DFUs on wound closure rates,treatment duration,and quality of life outcomes.METHODS This systematic review and meta-analysis followed PRISMA guidelines,systematically searching PubMed,Embase,Web of Science,and the Cochrane Library with no date restrictions.Randomized controlled trials(RCTs)that evaluated the efficacy of UAWD in DFU treatment were included.Data were independently extracted by two reviewers,with discrepancies resolved through consensus or third-party consultation.The risk of bias was assessed using the Cochrane tool.χ2 and I2 statistics assessed heterogeneity,informing the use of fixed or random-effects models for meta-analysis,supplemented by sensitivity analysis and publication bias assessment through funnel plots and Egger's test.RESULTS From 1255 articles,seven RCTs met the inclusion criteria.The studies demonstrated that UAWD significantly reduced DFU healing time(standardized mean difference=-0.78,95%CI:-0.97 to-0.60,P<0.001)and increased healing rates(odds ratio=9.96,95%CI:5.99 to 16.56,P<0.001)compared to standard care.Sensitivity analysis confirmed the stability of these results,and no significant publication bias was detected.CONCLUSION UAWD is a promising adjunctive treatment for DFUs,significantly reducing healing times and increasing healing rates.These findings advocate for the integration of UAWD into standard DFU care protocols.展开更多
Objectives:This systematic review and meta-analysis aimed to identify and synthesize the factors correlated with posttraumatic growth(PTG)in patients with colorectal cancer(CRC).Methods:PubMed,Web of Science,Embase,Ps...Objectives:This systematic review and meta-analysis aimed to identify and synthesize the factors correlated with posttraumatic growth(PTG)in patients with colorectal cancer(CRC).Methods:PubMed,Web of Science,Embase,PsycINFO,CINAHL,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang database,China Science and Technology Journal Database(VIP)and SinoMed were searched for studies that reported data on the correlated factors associated with PTG in patients with CRC from inception to September 3,2024.The methodological quality of the included studies was assessed via the Agency for Healthcare Research and Quality(AHRQ)methodology checklist and the Newcastle-Ottawa Scale(NOS).Pearson correlation coefficient(r)was utilized to indicate effect size.Meta-analysis was conducted in R Studio.Results:Thirty-one eligible studies encompassing 6,400 participants were included in this review.Correlated factors were identified to be significantly associated with PTG in patients with CRC including demographic factors:residential area(r=0.13),marital status(r=0.10),employment status(r=0.18),education level(r=0.19),income level(r=0.16);disease-related factors:time since surgery(r=0.17),stoma-related complications(r=0.14),health-promoting behavior(r=0.46),and sexual function(r=0.17);psychosocial factors:confrontation coping(r=0.68),avoidance coping(r=-0.65),deliberate rumination(r=0.56),social support(r=0.47),family function(r=0.50),resilience(r=0.53),selfefficacy(r=0.91),self-compassion(r=-0.32),psychosocial adjustment(r=0.39),gratitude(r=0.45),stigma(r=-0.65),self-perceived burden(r=-0.31),fear of cancer recurrence(r=-0.45);and quality of life(r=0.32).Conclusions:This meta-analysis identified 23 factors associated with PTG in CRC patients.Medical workers can combine those relevant factors from the perspective of positive psychology,further explore the occurrence and development mechanism of PTG,and establish targeted interventions to promote PTG.展开更多
BACKGROUND Cholangiocarcinoma(CCA)comprises heterogeneous malignancies arising at different anatomical locations:Intrahepatic cholangiocarcinoma(IHCC),perihilar cholangiocarcinoma(PHCC),and distal cholangiocarcinoma(D...BACKGROUND Cholangiocarcinoma(CCA)comprises heterogeneous malignancies arising at different anatomical locations:Intrahepatic cholangiocarcinoma(IHCC),perihilar cholangiocarcinoma(PHCC),and distal cholangiocarcinoma(DCC).These subtypes exhibit distinct clinical behaviors,treatment approaches,and outcomes.Despite advances in surgical and adjuvant therapies,the prognostic implications of tumor location remain unclear and inconsistently reported.Understanding these variations is essential for personalized management and staging refinement.We hypothesized that the anatomical subtype of CCA significantly influences prognostic outcomes and pathological features.AIM To compare prognostic outcomes and clinicopathological characteristics among IHCC,PHCC,and DCC based on current evidence.METHODS A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines.PubMed,EMBASE,and the Cochrane Library were searched,yielding 11 eligible retrospective comparative studies involving 14484 patients(IHCC:6260;PHCC:6895;DCC:1329).Outcomes assessed included overall survival(OS),lymph node metastasis,neural invasion,and vascular invasion.Statistical analyses were performed using RevMan 5.3 and Stata 13.0.RESULTS DCC demonstrated the most favorable prognosis among all subtypes.Despite the highest lymph node metastasis rate(DCC:56.9%),it was associated with better OS than PHCC and IHCC.Vascular invasion was more prevalent in IHCC(OR=1.66,95%CI:1.22-2.28,P=0.001).OS comparisons showed no significant difference between PHCC and IHCC(HR=1.02,P=0.88),while DCC showed consistent trends toward better survival against both.CONCLUSION Anatomical subtype is a significant prognostic factor in CCA.DCC patients experience superior outcomes despite aggressive lymphatic spread,suggesting better resectability and surgical outcomes.These insights underscore the need for subtype-specific management strategies and future prospective validation.展开更多
Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase bra...Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase brain-derived neurotrophic factor levels in children and adolescents, the effects of specific types of exercise on brain-derived neurotrophic factor levels are still controversial. To address this issue, we used meta-analytic methods to quantitatively evaluate, analyze, and integrate relevant studies. Our goals were to formulate general conclusions regarding the use of exercise interventions, explore the physiological mechanisms by which exercise improves brain health and cognitive ability in children and adolescents, and provide a reliable foundation for follow-up research. We used the Pub Med, Web of Science, Science Direct, Springer, Wiley Online Library, Weipu, Wanfang, and China National Knowledge Infrastructure databases to search for randomized controlled trials examining the influences of exercise interventions on brain-derived neurotrophic factor levels in children and adolescents. The extracted data were analyzed using Review Manager 5.3. According to the inclusion criteria, we assessed randomized controlled trials in which the samples were mainly children and adolescents, and the outcome indicators were measured before and after the intervention. We excluded animal experiments, studies that lacked a control group, and those that did not report quantitative results. The mean difference(MD;before versus after intervention) was used to evaluate the effect of exercise on brain-derived neurotrophic factor levels in children and adolescents. Overall, 531 participants(60 children and 471 adolescents, 10.9–16.1 years) were included from 13 randomized controlled trials. Heterogeneity was evaluated using the Q statistic and I^(2) test provided by Review Manager software. The meta-analysis showed that there was no heterogeneity among the studies(P = 0.67, I^(2) = 0.00%). The combined effect of the interventions was significant(MD = 2.88, 95% CI: 1.53–4.22, P < 0.0001), indicating that the brain-derived neurotrophic factor levels of the children and adolescents in the exercise group were significantly higher than those in the control group. In conclusion, different types of exercise interventions significantly increased brain-derived neurotrophic factor levels in children and adolescents. However, because of the small sample size of this meta-analysis, more high-quality research is needed to verify our conclusions. This metaanalysis was registered at PROSPERO(registration ID: CRD42023439408).展开更多
BACKGROUND The management of severe symptomatic aortic stenosis has been revolutionized by transcatheter aortic valve replacement(TAVR),offering a minimally invasive alternative to surgical aortic valve replacement(SA...BACKGROUND The management of severe symptomatic aortic stenosis has been revolutionized by transcatheter aortic valve replacement(TAVR),offering a minimally invasive alternative to surgical aortic valve replacement(SAVR).However,the compara-tive safety and efficacy of these interventions remain subjects of ongoing investigation.AIM To compare the clinical outcomes and safety of TAVR vs SAVR in patients with severe symptomatic aortic stenosis.METHODS A systematic review and meta-analysis were conducted according to PRISMA guidelines.Randomized controlled trials(RCTs)comparing TAVR and SAVR were identified from databases including PubMed,Scopus,and Web of Science up to May 31,2024.Data were extracted on clinical outcomes,including mortality,procedural compli-cations,and post-procedure adverse events.Risk ratios(RRs)with 95%CIs were calculated using a random-effects model.RESULTS A total of 10 RCTs were included.TAVR demonstrated a significantly lower risk of acute kidney injury(RR:0.33;95%CI:0.25–0.44),major bleeding(RR:0.37;95%CI:0.30–0.46),and new-onset atrial fibrillation(RR:0.44;95%CI:0.34–0.57)compared to SAVR.However,TAVR was associated with higher risks of new permanent pacemaker implantation(RR:3.49;95%CI:2.77–4.39),major vascular complications(RR:2.47;95%CI:1.91–3.21),and paraval-vular leaks(RR:4.15;95%CI:3.14–5.48).Mortality at 30 days was comparable(RR:0.95;95%CI:0.78–1.15),but long-term mortality was slightly higher with TAVR in some analyses(RR:1.23;95%CI:1.01–1.49).Rates of stroke(RR:0.97;95%CI:0.81–1.17)and myocardial infarction(RR:0.91;95%CI:0.67–1.24)were similar between the groups.CONCLUSION TAVR offers a less invasive option with significant benefits in reducing acute kidney injury,major bleeding,and new-onset atrial fibrillation,making it particularly advantageous for high-risk surgical candidates.However,higher risks of permanent pacemaker implantation,vascular complications,and paravalvular leaks highlight the need for individualized patient selection and shared decision-making to optimize outcomes.展开更多
Purpose–The brake pipe system was an essential braking component of the railway freight trains,but the existing E-type sealing rings had problems such as insufficient low-temperature resistance,poor heat stability an...Purpose–The brake pipe system was an essential braking component of the railway freight trains,but the existing E-type sealing rings had problems such as insufficient low-temperature resistance,poor heat stability and short service life.To address these issues,low-phenyl silicone rubber was prepared and tested,and the finite element analysis and experimental studies on the sealing performance of its sealing rings were carried out.Design/methodology/approach–The low-temperature resistance and thermal stability of the prepared lowphenyl silicone rubber were studied using low-temperature tensile testing,differential scanning calorimetry,dynamic thermomechanical analysis and thermogravimetric analysis.The sealing performance of the lowphenyl silicone rubber sealing ring was studied by using finite element analysis software abaqus and experiments.Findings–The prepared low-phenyl silicone rubber sealing ring possessed excellent low-temperature resistance and thermal stability.According to the finite element analysis results,the finish of the flange sealing surface and groove outer edge should be ensured,and extrusion damage should be avoided.The sealing rings were more susceptible to damage in high compression ratio and/or low-temperature environments.When the sealing effect was ensured,a small compression ratio should be selected,and rubbers with hardness and elasticity less affected by temperature should be selected.The prepared low-phenyl silicone rubber sealing ring had zero leakage at both room temperature(RT)and�508C.Originality/value–The innovation of this study is that it provides valuable data and experience for the future development of the sealing rings used in the brake pipe flange joints of the railway freight cars in China.展开更多
This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinom...This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinoma(HCC).This meta-analysis suggests that therapeutic combinations have greater efficacy than do standard treatments.The article highlights the key insights that have the potential to shift current clinical practice and enhance outcomes for patients with advanced HCC.Additionally,this article discusses further research that can be conducted to optimize these treatments and achieve personalized care for patients with HCC.展开更多
In this work,we compute the Grothendieck groups of finite 2-Calabi-Yau triangulated categories with maximal rigid objects which are not cluster tilting.These finite 2-Calabi-Yau triangulated categories are divided int...In this work,we compute the Grothendieck groups of finite 2-Calabi-Yau triangulated categories with maximal rigid objects which are not cluster tilting.These finite 2-Calabi-Yau triangulated categories are divided into,by the work of Amiot[Bull.Soc.Math.France,2007,135(3):435-474](see also[Adv.Math.,2008,217(6):2443-2484]and[J.Algebra,2016,446:426-449]),three classes:type A,type D and type E.展开更多
This paper presents a nonlinear micropolar nonclassical continuum theory (MPNCCT) for finite deformation, finite strain deformation physics of thermosviscoelastic solid medium with memory (polymeric micropolar solids)...This paper presents a nonlinear micropolar nonclassical continuum theory (MPNCCT) for finite deformation, finite strain deformation physics of thermosviscoelastic solid medium with memory (polymeric micropolar solids) based on classical rotations cΘand their rates. Contravariant second Piola-Kirchhoff stress and moment tensors, in conjunction with finite deformation measures derived by the authors in recent paper, are utilized in deriving the conservation and balance laws and the constitutive theories based on conjugate pairs in entropy inequality and the representation theorem. This nonlinear MPNCCT for TVES with rheology: 1) incorporates nonlinear ordered rate dissipation mechanism based on Green’s strain rates up to order n;2) also incorporates an additional ordered rate dissipation mechanism due to microconstituents, the viscosity of the medium and the rates of the symmetric part of the rotation gradient (of cΘ) tensor up to order n, referred to as micropolar dissipation or micropolar viscous dissipation mechanism;3) incorporates the primary mechanism of memory or rheology due to long chain molecules of the polymer and the viscosity of the medium by using the contravaraint second Piola-Kirchhoff stress tensor and its rates up to order m, resulting in a relaxation spectrum;4) incorporates second mechanism of memory or rheology due to nonclassical physics, interaction of microconstituents with the viscous medium and long chain molecules by considering rates of the contravariant second Piola-Kirchhoff moment tensor up to order m, resulting in relaxation of second Piola-Kirchhoff moment tensor. This results in another relaxation spectrum for the second Piola-Kirchhoff moment tensor due to microconstituents, referred to as micropolar relaxation spectrum consisting of micropolar relaxation time constants of the material. This nonlinear MPNCCT for TVES with memory is thermodynamically and mathematically consistent, and the mathematical model consisting of conservation and balance laws and the constitutive theories has closure and naturally reduces to linear MPNCCT based on infinitesimal deformation assumption. BMM is the essential balance law for all MPNCCT and is used in the present work as well. In the absence of this balance law, a valid thermodynamically and mathematically consistent nonlinear MPNCCT is not possible. The nonlinear MPNCCT based on rotations (cΘ+αΘ) and αΘ(ignoring cΘ) is not considered due to the fact that even the linear MPNCCT based on these rotations is invalid and is thermodynamically and mathematically inconsistent MPNCCT.展开更多
Objective: To compare the stress distribution in the periodontal ligament under different orthodontic forces during canine distalization using long-arm brackets, and to determine the optimal force value for this devic...Objective: To compare the stress distribution in the periodontal ligament under different orthodontic forces during canine distalization using long-arm brackets, and to determine the optimal force value for this device in orthodontic treatment. Methods: A finite element model was constructed after extracting the mandibular first premolar, and a long-arm bracket with a traction height of 6 mm was placed on the labial side of the mandibular canine. Three working conditions of 50 g, 100 g, and 150 g were simulated, and the magnitude and distribution of von Mises stress in the periodontal ligament were compared for each condition. Results: The maximum von Mises stress in the periodontal ligament was 0.013281 MPa in the 50 g condition, 0.02536 MPa in the 100 g condition, and 0.035549 MPa in the 150 g condition. As the orthodontic force increased, the stress distribution area in the periodontal ligament also expanded. Conclusion: A 100 g orthodontic force is the most suitable when using long-arm brackets, providing a relatively uniform stress distribution in the periodontal ligament and keeping the stress within a reasonable range.展开更多
[Objectives]To systematically evaluate the effects of electroacupuncture(EA)on post-stroke apoptosis in animal models,focusing on key apoptotic markers(TUNEL-positive cells,caspase-3,Bcl-2/Bax ratio)and exploring pote...[Objectives]To systematically evaluate the effects of electroacupuncture(EA)on post-stroke apoptosis in animal models,focusing on key apoptotic markers(TUNEL-positive cells,caspase-3,Bcl-2/Bax ratio)and exploring potential sources of heterogeneity related to EA parameters and the timing of interventions.[Methods]A comprehensive search of PubMed,EMBASE,Web of Science,and the Cochrane Library(from inception to July 2025)was conducted to identify randomized controlled animal studies investigating EA in ischemic stroke models(tMCAO/pMCAO).Data pertaining to apoptotic outcomes were extracted,and the methodological quality was assessed using the CAMARADES checklist.A meta-analysis was conducted using random-or fixed-effects models in Stata 17.0,with subgroup analyses for EA timing(pre-vs.post-ischemia)and waveforms(continuous vs.disperse).Heterogeneity among studies was quantified via the I 2 statistic.[Results]Thirty-two studies were included in the analysis.EA significantly reduced apoptosis,as evidenced by a decrease in TUNEL-positive cells(Hedges'g=-3.38,95%CI:-4.09 to-2.67),reduced caspase-3 expression(g=-2.67,95%CI:-3.35 to-2.00),and an increased Bcl-2/Bax ratio(g=2.60,95%CI:1.72 to 3.47).Subgroup analyses showed comparable efficacy between pre-and post-ischemia EA(p=0.50)and revealed a non-significant trend favoring continuous over disperse waveforms(p=0.09).High heterogeneity(I 2>50%)was observed,which was attributed to variations in animal models,EA protocols,and outcome assessments.[Conclusions]EA demonstrates robust anti-apoptotic effects in stroke models,likely mediated through the PI3K/Akt,NF-κB,and TRPV1 pathways.While both timing and waveforms show promise,standardizing EA protocols and conducting translational clinical trials are essential to optimize neuroprotective applications in stroke rehabilitation.展开更多
This paper mainly studies the well-posedness of steady incompressible impinging jet flow problem through a 3D axisymmetric finitely long nozzle.This problem originates from the physical phenomena encountered in practi...This paper mainly studies the well-posedness of steady incompressible impinging jet flow problem through a 3D axisymmetric finitely long nozzle.This problem originates from the physical phenomena encountered in practical engineering fields,such as in short take-off and vertical landing(STOVL)aircraft.Nowadays many intricate phenomena associated with impinging jet flows remain inadequately elucidated,which limits the ability to optimize aircraft design.Given a boundary condition in the inlet,the impinging jet problem is transformed into a Bernoulli-type free boundary problem according to the stream function.Then the variational method is used to study the corresponding variational problem with one parameter,thereby the wellposedness is established.The main conclusion is as follows.For a 3D axisymmetric finitely long nozzle and an infinitely long vertical wall,given an axial velocity in the inlet of nozzle,there exists a unique smooth incom‑pressible impinging jet flow such that the free boundary initiates smoothly at the endpoint of the nozzle and extends to infinity along the vertical wall at far fields.The key point is to investigate the regularity of the corner where the nozzle and the vertical axis intersect.展开更多
BACKGROUND Diabetes is an epidemic condition affecting people globally with a high rate of morbidity and mortality.While various pharmacological and non-pharmacological treatment options are used,diabetes is still a n...BACKGROUND Diabetes is an epidemic condition affecting people globally with a high rate of morbidity and mortality.While various pharmacological and non-pharmacological treatment options are used,diabetes is still a non-treatable condition.Constant attempts are made to identify newer therapies that could support better management of the diabetes condition and improve overall quality of life.Numerous studies have supported the potential role of probiotics therapy in the diabetes condition.AIM To evaluate the efficacy of triple probiotic combination on glycaemic,metabolic,oxidative stress,and inflammatory parameters in the diabetic population.METHODS Randomized controlled trials evaluating the efficacy of the triple probiotic combination in diabetic patients were identified.The quality of the studies was evaluated using the PEDro scale while biasness between and within the studies was assessed using the Risk of Bias tool.Meta-analysis was conducted using RevMan software,and sensitivity analysis was performed using OpenMeta Analyst software.The study protocol was registered in PROSPERO(CRD42-024530999).RESULTS Five good-quality clinical trials were included.Low-to-moderate risk of bias was observed.Data from 300 participants were included(150 participants in both groups).Probiotics supplementation significantly improved glycaemic and insulin parameters(glucose level:-23.86 mg/dL;insulin level:-5.02μIU/mL;HOMA-IR:-1.82 score;QUICKI:+0.02 score;HOMA-B:-16.30 score;P<0.05 for all parameters),reduced oxidative stress and improved antioxidant parameters[TAC:+92.55 mmol/L;glutathione(GSH):+40.55μmol/L;nitric oxide(NO):+6.45μmol/L;malondialdehyde(MDA):-0.48μmol/L;hs-CRP:-2.24 mg/L;P<0.05 for all parameters except GSH],and improved lipid parameters(total cholesterol(TC):-3.43 mg/dL;triglycerides(TG):-4.26 mg/dL;low-density lipoprotein:-4.62 mg/dL;very low-density lipoprotein:-0.83 mg/dL;high-density lipoprotein(HDL):+1.83 mg/dL;TC/HDL ratio:-0.25;P<0.05 for HDL and TC/HDL ratio parameters)compared to the control group.CONCLUSION The combination of L.acidophilus,L.casei,and B.bifidum is effective in diabetic patients with cardio/renal complications.Further well-designed studies are warranted to support the results of current research.展开更多
BACKGROUND There is a need to synthesize the different patterns of fever treatment and phobias in Nigeria and to document these behavioral issues among caregivers.Although,fever is commonly seen in children and this m...BACKGROUND There is a need to synthesize the different patterns of fever treatment and phobias in Nigeria and to document these behavioral issues among caregivers.Although,fever is commonly seen in children and this make the mothers to seek medical care when all effort of theirs have failed.Yet,this behavioral and anxiety disorders among mothers still persists several years after the word“Fever phobia”was coined.AIM To document the knowledge of fever among Nigerian mothers and to determine heterogeneity in these practices across the nation.METHODS A search of articles on fever phobias among mothers or caregivers in Nigeria was performed via the Cochrane Database of Systematic Reviews,PubMed,Google Scholar,and MEDLINE.Articles published between 2008,and 2023 were included in the study.The keywords used in the literature search included fever,phobias,perceptions,mothers,caregivers,perceptions,drugs,knowledge,and practices.Boolean operators were also used in the search for items,such as“fever AND phobia”,“fever AND perception”,“fever AND mothers”,“fevers AND/OR phobia”,“AND OR mothers/caregivers”,to help narrow parameters in the search engine and enhance reproducibility.Studies that fulfilled the inclusion criteria were presented via the PRISMA model.I2 statistics were used to assess heterogeneity.RESULTS The studies show wide variation in the reported levels of knowledge about fever,with proportions ranging from as low as 35%to as high as 94%.The pooled proportion estimate using the common effect model is 65%(95%CI:64%-67%),assuming that all studies reflect a single underlying value.However,the random effects model,which accounts for differences among studies,yields a higher estimate of 70%(95%CI:56%-82%).This divergence reflects significant heterogeneity in the data,with a Tau^(2)of 0.7007,I²of 95.7%,and,an H statistic of 4.80,all indicating that most of the variability is due to actual differences among studies rather than random chance.The Q test further confirms this,with a P value less than 0.0001,reinforcing that the variability across studies is statistically significant.The subgroup analysis revealed that studies in Group A(six studies)reported a pooled knowledge proportion of 75%,with a confidence interval ranging from 56%to 88%,and relatively lower heterogeneity(Tau^(2)=0.5709,Tau=0.7556),indicating greater consistency in their findings.In contrast,Group B(four studies)had a lower pooled estimate of 62%,but with a much wider confidence interval(27%to 88%)and greater heterogeneity(Tau^(2)=0.8380,Tau=0.9154),suggesting greater variation across studies in that group.Fear of brain damage,convulsions,witches/wizards,and death was high in many of the studies.Herbal concoctions,and prayers were the mostly used measures to cure fever by mothers.CONCLUSION Mothers’knowledge of fever detection in children is low.There was heterogeneity in the sample size of the studies,which may have affected the knowledge of fever.展开更多
Design a precision electroplating mechanical structure for automobiles based on finite element analysis method and analyze its mechanical properties.Taking the automobile steering knuckle as the research object,ABAQUS...Design a precision electroplating mechanical structure for automobiles based on finite element analysis method and analyze its mechanical properties.Taking the automobile steering knuckle as the research object,ABAQUS parametric modeling technology is used to construct its three-dimensional geometric model,and geometric simplification is carried out.Two surface treatment processes,HK-35 zinc nickel alloy electroplating and pure zinc electroplating,were designed,and the influence of different coatings on the mechanical properties of steering knuckles was compared and analyzed through numerical simulation.At the same time,standard specimens were prepared for salt spray corrosion testing and scratch method combined strength testing to verify the numerical simulation results.The results showed that under emergency braking and composite working conditions,the peak Von Mises stress of the zinc nickel alloy coating was 119.85 MPa,which was lower than that of the pure zinc coating and the alkaline electroplated zinc layer.Its equivalent strain value was 652×10^(-6),which was lower than that of the pure zinc coating and the alkaline electroplated zinc layer.Experimental data confirms that zinc nickel alloy coatings exhibit significant advantages in stress distribution uniformity,strain performance,and load-bearing capacity in high stress zones.The salt spray corrosion test further indicates that the coating has superior corrosion resistance and coating substrate interface bonding strength,which can significantly improve the mechanical stability and long-term reliability of automotive precision electroplating mechanical structures.展开更多
Background Temporomandibular disorders(TMD)are the leading cause of chronic orofacial pain,which significantly affects patients’quality of life.However,the efficacy of acupuncture in the management of TMD remains unc...Background Temporomandibular disorders(TMD)are the leading cause of chronic orofacial pain,which significantly affects patients’quality of life.However,the efficacy of acupuncture in the management of TMD remains unclear.Objective This systematic review aimed to conduct a PRISMA-compliant review to critically assess the therapeutic efficacy of acupuncture as an intervention for patients with TMD.Methods We searched nine electronic databases for randomized controlled trials on acupuncture for TMD published up to February 4,2025.Eligible studies included adults diagnosed with TMD and compared acupuncture(manual,electroacupuncture,warm,auricular,thread-embedding,or laser)with conservative treatment(positive control)or sham acupuncture(negative control).Outcomes included pain intensity,mouth opening,pressure pain threshold,and adverse events.Risk of bias was assessed using ROB 2,and certainty of evidence was evaluated using GRADE.All outcome data were analyzed using RevMan 5.4 software.Low heterogeneity was defined as I^(2)≤50% and P≥0.1,in which case a fixed-effects model was applied.High heterogeneity(I^(2)>50% or P<0.1)prompted further analysis to identify its source.After excluding the influence of evident heterogeneity,a random-effects model was used for the meta-analysis.Results Of the 2664 screened records,14 randomized controlled trials involving 476 participants met the inclusion criteria.Acupuncture significantly reduced pain intensity compared with that of negative controls(MD=-1.75,95%confidence interval[CI]-2.47 to-1.03;P<0.00001;I^(2)=60%)but showed no difference compared with that of positive controls(MD=-0.06,95%CI-0.62 to 0.50;P=0.83;I^(2)=0%).No significant differences were observed in pain-free jaw opening,whereas acupuncture improved maximum mouth opening relative to negative controls(MD=1.80,95%CI 1.62 to 1.97;P<0.00001;I^(2)=0%).For pressure pain threshold,two small studies suggested greater increases with acupuncture.Safety data were limited,with only one trial reporting mild adverse events in the acupuncture group.Conclusion Based on limited evidence,acupuncture appears superior to negative controls in relieving pain associated with TMD but shows no significant advantage over positive controls.The certainty of the evidence for all outcomes,as assessed by GRADE,was low or very low.Therefore,these findings should be interpreted with caution.Future high-quality randomized controlled trials are warranted to further evaluate the role of acupuncture in the management of patients with TMD.展开更多
This study presents a systematic review of xu-based studies in an attempt to clarify the construct of the xu-argument and the effectiveness of continuation tasks in foreign language learning.This review adopted a meta...This study presents a systematic review of xu-based studies in an attempt to clarify the construct of the xu-argument and the effectiveness of continuation tasks in foreign language learning.This review adopted a meta-analytic procedure consisting of effect-size aggregation and moderator analysis.While the former quantitatively synthesized evidence in support of xu-based interventions,the latter contextualized evidence in relation to learner and task features.Meta-analytic results indicated a medium-to-large effect of xu-based interventions for foreign language learning(g=1.18 and g=0.49 for within-group and between-group contrasts respectively).This effect was comparatively larger for(a)university-level students,(b)multilingual settings,(c)foreign languages other than English(LOTEs),(d)longer instructional treatments,and(e)specific language features.We interpret supportive evidence for xu-based interventions with respect to theoretical,methodological and pedagogical relevance,and provide empirically grounded recommendations for future task design and research on xu-based practices.展开更多
Resistant starch(RS)has attracted much researchers'attention because of its health-beneficial effects.Gut microbiota obviously shapes human health,but the effects of RS supplementation on the changes of human gut ...Resistant starch(RS)has attracted much researchers'attention because of its health-beneficial effects.Gut microbiota obviously shapes human health,but the effects of RS supplementation on the changes of human gut microbiota remain unclear.This observational meta-analysis aimed to reveal the effects of RS intake onα-diversity and composition of gut microbiota through meta-analysis.Two independent authors systematically searched articles from inception until February 2023 on four electronic databases.Twenty-four highly relevant trials were included conforming to Preferred Reporting Items for Systematic reviews and MetaAnalysis protocol,and a total of 816 individuals were included.Significant heterogeneity analyses revealed that RS intake notably decreased Shannon index(weighted mean difference(WMD):-0.11;95%confidence interval(CI):-0.21,-0.01),and stimulated the composition of health promoting bacteria genera,including Bifidobacterium(relative abundance:WMD:1.75;95%CI:0.39,3.11;bacterial populations:WMD:0.36;95%CI:0.04,0.69),Faecalibacterium(relative abundance:WMD:0.70;95%CI:0.20,1.20;fold change:effect size:0.91;95%CI:0.60,1.23),and Prevotella(relative abundance:WMD:0.35;95%CI:0.01,0.69).Taken together,the present study revealed that changes in the gut microbiota diversity and genera were correlated with RS supplementation,which may contribute to benefits in human health.展开更多
Objective: To explore the factors affecting the psychological pain of patients with enterostomy through meta-analysis, with the aim of reducing psychological pain and improving patients’ quality of life. Methods: Pub...Objective: To explore the factors affecting the psychological pain of patients with enterostomy through meta-analysis, with the aim of reducing psychological pain and improving patients’ quality of life. Methods: Published literature on psychological pain in enterostomy patients was retrieved from Chinese and English databases, including CNKI, Wanfang, VIP, China Biomedical Network, PubMed, Embase, Ovid, and Web of Science. The search period covered the establishment of the databases until October 2024. Literature was screened based on inclusion and exclusion criteria, and its quality was evaluated. Data analysis was performed using R Studio software. Results: A total of 2,237 articles involving 1,221 patients with enterostomy and 11 influencing factors were identified. The results of the meta-analysis indicated that age, marital status, ostomy complications, self-care ability, pain severity, and sleep quality were the primary contributors to psychological distress. Conclusion: Multiple factors influence psychological pain in enterostomy patients. Medical staff should prioritize addressing these factors to alleviate psychological pain and enhance patients’ quality of life.展开更多
Background:Bacterial pneumonia continues to be a significant global health concern,particularly among high-risk groups,necessitating the development of precise and early diagnostic biomarkers.While the efficacy of pro...Background:Bacterial pneumonia continues to be a significant global health concern,particularly among high-risk groups,necessitating the development of precise and early diagnostic biomarkers.While the efficacy of procalcitonin(PCT)and C-reactive protein(CRP)as inflammatory markers is widely recognized,their relative diagnostic performance across different age groups remains debate.This meta-analysis was designed to assess the diagnostic accuracy of PCT and CRP in bacterial pneumonia.Methods:In this meta-analysis adhering to PRISMA guidelines,we searched PubMed,Web of Science,and the Cochrane Library for relevant diagnostic accuracy studies.From 19 included studies(n=2,603),data were extracted to construct tables.Study quality was assessed with the QUADAS-2 tool.The bivariate random-effects model was employed to derive pooled sensitivity,specificity,positive and negative likelihood ratios,and summary AUCs.To explore the substantial heterogeneity(I^(2)>80%),we performed pre-specified subgroup analyses based on age demographics.Results:Our findings indicate superior diagnostic performance for PCT,evidenced by a pooled sensitivity of 0.8841 and specificity of 0.8499,relative to CRP’s sensitivity of 0.8371 and specificity of 0.7185.The area under the ROC curve(AUC)for PCT was 0.992,a value significantly higher than that of CRP(0.987).Intriguingly,subgroup analyses revealed age-dependent variations:CRP demonstrated enhanced diagnostic utility in minors,while PCT proved substantially more effective in non-elderly adults.Conclusion:These results reinforce the clinical relevance of PCT as a more dependable biomarker for bacterial pneumonia,particularly in informing antibiotic treatment and mitigating misuse.This study uniquely includes age-stratified analyses based on predefined groups(minors and non-elderly adults),providing refined insights for individualized diagnostic approaches.We propose further multicenter research endeavors to confirm threshold optimization and explore combined biomarker strategies.展开更多
基金Hubei Province Top Medical Youth Talent Program,Wuhan Knowledge Innovation Special Basic Research Project,No.2023020201020558Clinical Research Project of Affiliated Hospital of Guangdong Medical University,No.LCYJ2021B004 and No.LCYJ2019B010Science and Technology Plan Project of Zhanjiang,No.2022A01191.
文摘BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therapeutic modality to improve healing outcomes in DFU management.AIM To evaluate the efficacy of UAWD in treating DFUs on wound closure rates,treatment duration,and quality of life outcomes.METHODS This systematic review and meta-analysis followed PRISMA guidelines,systematically searching PubMed,Embase,Web of Science,and the Cochrane Library with no date restrictions.Randomized controlled trials(RCTs)that evaluated the efficacy of UAWD in DFU treatment were included.Data were independently extracted by two reviewers,with discrepancies resolved through consensus or third-party consultation.The risk of bias was assessed using the Cochrane tool.χ2 and I2 statistics assessed heterogeneity,informing the use of fixed or random-effects models for meta-analysis,supplemented by sensitivity analysis and publication bias assessment through funnel plots and Egger's test.RESULTS From 1255 articles,seven RCTs met the inclusion criteria.The studies demonstrated that UAWD significantly reduced DFU healing time(standardized mean difference=-0.78,95%CI:-0.97 to-0.60,P<0.001)and increased healing rates(odds ratio=9.96,95%CI:5.99 to 16.56,P<0.001)compared to standard care.Sensitivity analysis confirmed the stability of these results,and no significant publication bias was detected.CONCLUSION UAWD is a promising adjunctive treatment for DFUs,significantly reducing healing times and increasing healing rates.These findings advocate for the integration of UAWD into standard DFU care protocols.
基金supported by the‘Double First-Class’Construction Specialized Discipline Project at Zhejiang University(No HL2024012).
文摘Objectives:This systematic review and meta-analysis aimed to identify and synthesize the factors correlated with posttraumatic growth(PTG)in patients with colorectal cancer(CRC).Methods:PubMed,Web of Science,Embase,PsycINFO,CINAHL,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang database,China Science and Technology Journal Database(VIP)and SinoMed were searched for studies that reported data on the correlated factors associated with PTG in patients with CRC from inception to September 3,2024.The methodological quality of the included studies was assessed via the Agency for Healthcare Research and Quality(AHRQ)methodology checklist and the Newcastle-Ottawa Scale(NOS).Pearson correlation coefficient(r)was utilized to indicate effect size.Meta-analysis was conducted in R Studio.Results:Thirty-one eligible studies encompassing 6,400 participants were included in this review.Correlated factors were identified to be significantly associated with PTG in patients with CRC including demographic factors:residential area(r=0.13),marital status(r=0.10),employment status(r=0.18),education level(r=0.19),income level(r=0.16);disease-related factors:time since surgery(r=0.17),stoma-related complications(r=0.14),health-promoting behavior(r=0.46),and sexual function(r=0.17);psychosocial factors:confrontation coping(r=0.68),avoidance coping(r=-0.65),deliberate rumination(r=0.56),social support(r=0.47),family function(r=0.50),resilience(r=0.53),selfefficacy(r=0.91),self-compassion(r=-0.32),psychosocial adjustment(r=0.39),gratitude(r=0.45),stigma(r=-0.65),self-perceived burden(r=-0.31),fear of cancer recurrence(r=-0.45);and quality of life(r=0.32).Conclusions:This meta-analysis identified 23 factors associated with PTG in CRC patients.Medical workers can combine those relevant factors from the perspective of positive psychology,further explore the occurrence and development mechanism of PTG,and establish targeted interventions to promote PTG.
文摘BACKGROUND Cholangiocarcinoma(CCA)comprises heterogeneous malignancies arising at different anatomical locations:Intrahepatic cholangiocarcinoma(IHCC),perihilar cholangiocarcinoma(PHCC),and distal cholangiocarcinoma(DCC).These subtypes exhibit distinct clinical behaviors,treatment approaches,and outcomes.Despite advances in surgical and adjuvant therapies,the prognostic implications of tumor location remain unclear and inconsistently reported.Understanding these variations is essential for personalized management and staging refinement.We hypothesized that the anatomical subtype of CCA significantly influences prognostic outcomes and pathological features.AIM To compare prognostic outcomes and clinicopathological characteristics among IHCC,PHCC,and DCC based on current evidence.METHODS A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines.PubMed,EMBASE,and the Cochrane Library were searched,yielding 11 eligible retrospective comparative studies involving 14484 patients(IHCC:6260;PHCC:6895;DCC:1329).Outcomes assessed included overall survival(OS),lymph node metastasis,neural invasion,and vascular invasion.Statistical analyses were performed using RevMan 5.3 and Stata 13.0.RESULTS DCC demonstrated the most favorable prognosis among all subtypes.Despite the highest lymph node metastasis rate(DCC:56.9%),it was associated with better OS than PHCC and IHCC.Vascular invasion was more prevalent in IHCC(OR=1.66,95%CI:1.22-2.28,P=0.001).OS comparisons showed no significant difference between PHCC and IHCC(HR=1.02,P=0.88),while DCC showed consistent trends toward better survival against both.CONCLUSION Anatomical subtype is a significant prognostic factor in CCA.DCC patients experience superior outcomes despite aggressive lymphatic spread,suggesting better resectability and surgical outcomes.These insights underscore the need for subtype-specific management strategies and future prospective validation.
基金supported by the STI 2030-Major Projects,No. 2021ZD0200500 (to XS)。
文摘Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase brain-derived neurotrophic factor levels in children and adolescents, the effects of specific types of exercise on brain-derived neurotrophic factor levels are still controversial. To address this issue, we used meta-analytic methods to quantitatively evaluate, analyze, and integrate relevant studies. Our goals were to formulate general conclusions regarding the use of exercise interventions, explore the physiological mechanisms by which exercise improves brain health and cognitive ability in children and adolescents, and provide a reliable foundation for follow-up research. We used the Pub Med, Web of Science, Science Direct, Springer, Wiley Online Library, Weipu, Wanfang, and China National Knowledge Infrastructure databases to search for randomized controlled trials examining the influences of exercise interventions on brain-derived neurotrophic factor levels in children and adolescents. The extracted data were analyzed using Review Manager 5.3. According to the inclusion criteria, we assessed randomized controlled trials in which the samples were mainly children and adolescents, and the outcome indicators were measured before and after the intervention. We excluded animal experiments, studies that lacked a control group, and those that did not report quantitative results. The mean difference(MD;before versus after intervention) was used to evaluate the effect of exercise on brain-derived neurotrophic factor levels in children and adolescents. Overall, 531 participants(60 children and 471 adolescents, 10.9–16.1 years) were included from 13 randomized controlled trials. Heterogeneity was evaluated using the Q statistic and I^(2) test provided by Review Manager software. The meta-analysis showed that there was no heterogeneity among the studies(P = 0.67, I^(2) = 0.00%). The combined effect of the interventions was significant(MD = 2.88, 95% CI: 1.53–4.22, P < 0.0001), indicating that the brain-derived neurotrophic factor levels of the children and adolescents in the exercise group were significantly higher than those in the control group. In conclusion, different types of exercise interventions significantly increased brain-derived neurotrophic factor levels in children and adolescents. However, because of the small sample size of this meta-analysis, more high-quality research is needed to verify our conclusions. This metaanalysis was registered at PROSPERO(registration ID: CRD42023439408).
文摘BACKGROUND The management of severe symptomatic aortic stenosis has been revolutionized by transcatheter aortic valve replacement(TAVR),offering a minimally invasive alternative to surgical aortic valve replacement(SAVR).However,the compara-tive safety and efficacy of these interventions remain subjects of ongoing investigation.AIM To compare the clinical outcomes and safety of TAVR vs SAVR in patients with severe symptomatic aortic stenosis.METHODS A systematic review and meta-analysis were conducted according to PRISMA guidelines.Randomized controlled trials(RCTs)comparing TAVR and SAVR were identified from databases including PubMed,Scopus,and Web of Science up to May 31,2024.Data were extracted on clinical outcomes,including mortality,procedural compli-cations,and post-procedure adverse events.Risk ratios(RRs)with 95%CIs were calculated using a random-effects model.RESULTS A total of 10 RCTs were included.TAVR demonstrated a significantly lower risk of acute kidney injury(RR:0.33;95%CI:0.25–0.44),major bleeding(RR:0.37;95%CI:0.30–0.46),and new-onset atrial fibrillation(RR:0.44;95%CI:0.34–0.57)compared to SAVR.However,TAVR was associated with higher risks of new permanent pacemaker implantation(RR:3.49;95%CI:2.77–4.39),major vascular complications(RR:2.47;95%CI:1.91–3.21),and paraval-vular leaks(RR:4.15;95%CI:3.14–5.48).Mortality at 30 days was comparable(RR:0.95;95%CI:0.78–1.15),but long-term mortality was slightly higher with TAVR in some analyses(RR:1.23;95%CI:1.01–1.49).Rates of stroke(RR:0.97;95%CI:0.81–1.17)and myocardial infarction(RR:0.91;95%CI:0.67–1.24)were similar between the groups.CONCLUSION TAVR offers a less invasive option with significant benefits in reducing acute kidney injury,major bleeding,and new-onset atrial fibrillation,making it particularly advantageous for high-risk surgical candidates.However,higher risks of permanent pacemaker implantation,vascular complications,and paravalvular leaks highlight the need for individualized patient selection and shared decision-making to optimize outcomes.
基金supported by the Science and Technology Research and Development Plan of the China State Railway Group Company Limited(No.Q2023J012).
文摘Purpose–The brake pipe system was an essential braking component of the railway freight trains,but the existing E-type sealing rings had problems such as insufficient low-temperature resistance,poor heat stability and short service life.To address these issues,low-phenyl silicone rubber was prepared and tested,and the finite element analysis and experimental studies on the sealing performance of its sealing rings were carried out.Design/methodology/approach–The low-temperature resistance and thermal stability of the prepared lowphenyl silicone rubber were studied using low-temperature tensile testing,differential scanning calorimetry,dynamic thermomechanical analysis and thermogravimetric analysis.The sealing performance of the lowphenyl silicone rubber sealing ring was studied by using finite element analysis software abaqus and experiments.Findings–The prepared low-phenyl silicone rubber sealing ring possessed excellent low-temperature resistance and thermal stability.According to the finite element analysis results,the finish of the flange sealing surface and groove outer edge should be ensured,and extrusion damage should be avoided.The sealing rings were more susceptible to damage in high compression ratio and/or low-temperature environments.When the sealing effect was ensured,a small compression ratio should be selected,and rubbers with hardness and elasticity less affected by temperature should be selected.The prepared low-phenyl silicone rubber sealing ring had zero leakage at both room temperature(RT)and�508C.Originality/value–The innovation of this study is that it provides valuable data and experience for the future development of the sealing rings used in the brake pipe flange joints of the railway freight cars in China.
文摘This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinoma(HCC).This meta-analysis suggests that therapeutic combinations have greater efficacy than do standard treatments.The article highlights the key insights that have the potential to shift current clinical practice and enhance outcomes for patients with advanced HCC.Additionally,this article discusses further research that can be conducted to optimize these treatments and achieve personalized care for patients with HCC.
文摘In this work,we compute the Grothendieck groups of finite 2-Calabi-Yau triangulated categories with maximal rigid objects which are not cluster tilting.These finite 2-Calabi-Yau triangulated categories are divided into,by the work of Amiot[Bull.Soc.Math.France,2007,135(3):435-474](see also[Adv.Math.,2008,217(6):2443-2484]and[J.Algebra,2016,446:426-449]),three classes:type A,type D and type E.
文摘This paper presents a nonlinear micropolar nonclassical continuum theory (MPNCCT) for finite deformation, finite strain deformation physics of thermosviscoelastic solid medium with memory (polymeric micropolar solids) based on classical rotations cΘand their rates. Contravariant second Piola-Kirchhoff stress and moment tensors, in conjunction with finite deformation measures derived by the authors in recent paper, are utilized in deriving the conservation and balance laws and the constitutive theories based on conjugate pairs in entropy inequality and the representation theorem. This nonlinear MPNCCT for TVES with rheology: 1) incorporates nonlinear ordered rate dissipation mechanism based on Green’s strain rates up to order n;2) also incorporates an additional ordered rate dissipation mechanism due to microconstituents, the viscosity of the medium and the rates of the symmetric part of the rotation gradient (of cΘ) tensor up to order n, referred to as micropolar dissipation or micropolar viscous dissipation mechanism;3) incorporates the primary mechanism of memory or rheology due to long chain molecules of the polymer and the viscosity of the medium by using the contravaraint second Piola-Kirchhoff stress tensor and its rates up to order m, resulting in a relaxation spectrum;4) incorporates second mechanism of memory or rheology due to nonclassical physics, interaction of microconstituents with the viscous medium and long chain molecules by considering rates of the contravariant second Piola-Kirchhoff moment tensor up to order m, resulting in relaxation of second Piola-Kirchhoff moment tensor. This results in another relaxation spectrum for the second Piola-Kirchhoff moment tensor due to microconstituents, referred to as micropolar relaxation spectrum consisting of micropolar relaxation time constants of the material. This nonlinear MPNCCT for TVES with memory is thermodynamically and mathematically consistent, and the mathematical model consisting of conservation and balance laws and the constitutive theories has closure and naturally reduces to linear MPNCCT based on infinitesimal deformation assumption. BMM is the essential balance law for all MPNCCT and is used in the present work as well. In the absence of this balance law, a valid thermodynamically and mathematically consistent nonlinear MPNCCT is not possible. The nonlinear MPNCCT based on rotations (cΘ+αΘ) and αΘ(ignoring cΘ) is not considered due to the fact that even the linear MPNCCT based on these rotations is invalid and is thermodynamically and mathematically inconsistent MPNCCT.
文摘Objective: To compare the stress distribution in the periodontal ligament under different orthodontic forces during canine distalization using long-arm brackets, and to determine the optimal force value for this device in orthodontic treatment. Methods: A finite element model was constructed after extracting the mandibular first premolar, and a long-arm bracket with a traction height of 6 mm was placed on the labial side of the mandibular canine. Three working conditions of 50 g, 100 g, and 150 g were simulated, and the magnitude and distribution of von Mises stress in the periodontal ligament were compared for each condition. Results: The maximum von Mises stress in the periodontal ligament was 0.013281 MPa in the 50 g condition, 0.02536 MPa in the 100 g condition, and 0.035549 MPa in the 150 g condition. As the orthodontic force increased, the stress distribution area in the periodontal ligament also expanded. Conclusion: A 100 g orthodontic force is the most suitable when using long-arm brackets, providing a relatively uniform stress distribution in the periodontal ligament and keeping the stress within a reasonable range.
文摘[Objectives]To systematically evaluate the effects of electroacupuncture(EA)on post-stroke apoptosis in animal models,focusing on key apoptotic markers(TUNEL-positive cells,caspase-3,Bcl-2/Bax ratio)and exploring potential sources of heterogeneity related to EA parameters and the timing of interventions.[Methods]A comprehensive search of PubMed,EMBASE,Web of Science,and the Cochrane Library(from inception to July 2025)was conducted to identify randomized controlled animal studies investigating EA in ischemic stroke models(tMCAO/pMCAO).Data pertaining to apoptotic outcomes were extracted,and the methodological quality was assessed using the CAMARADES checklist.A meta-analysis was conducted using random-or fixed-effects models in Stata 17.0,with subgroup analyses for EA timing(pre-vs.post-ischemia)and waveforms(continuous vs.disperse).Heterogeneity among studies was quantified via the I 2 statistic.[Results]Thirty-two studies were included in the analysis.EA significantly reduced apoptosis,as evidenced by a decrease in TUNEL-positive cells(Hedges'g=-3.38,95%CI:-4.09 to-2.67),reduced caspase-3 expression(g=-2.67,95%CI:-3.35 to-2.00),and an increased Bcl-2/Bax ratio(g=2.60,95%CI:1.72 to 3.47).Subgroup analyses showed comparable efficacy between pre-and post-ischemia EA(p=0.50)and revealed a non-significant trend favoring continuous over disperse waveforms(p=0.09).High heterogeneity(I 2>50%)was observed,which was attributed to variations in animal models,EA protocols,and outcome assessments.[Conclusions]EA demonstrates robust anti-apoptotic effects in stroke models,likely mediated through the PI3K/Akt,NF-κB,and TRPV1 pathways.While both timing and waveforms show promise,standardizing EA protocols and conducting translational clinical trials are essential to optimize neuroprotective applications in stroke rehabilitation.
文摘This paper mainly studies the well-posedness of steady incompressible impinging jet flow problem through a 3D axisymmetric finitely long nozzle.This problem originates from the physical phenomena encountered in practical engineering fields,such as in short take-off and vertical landing(STOVL)aircraft.Nowadays many intricate phenomena associated with impinging jet flows remain inadequately elucidated,which limits the ability to optimize aircraft design.Given a boundary condition in the inlet,the impinging jet problem is transformed into a Bernoulli-type free boundary problem according to the stream function.Then the variational method is used to study the corresponding variational problem with one parameter,thereby the wellposedness is established.The main conclusion is as follows.For a 3D axisymmetric finitely long nozzle and an infinitely long vertical wall,given an axial velocity in the inlet of nozzle,there exists a unique smooth incom‑pressible impinging jet flow such that the free boundary initiates smoothly at the endpoint of the nozzle and extends to infinity along the vertical wall at far fields.The key point is to investigate the regularity of the corner where the nozzle and the vertical axis intersect.
文摘BACKGROUND Diabetes is an epidemic condition affecting people globally with a high rate of morbidity and mortality.While various pharmacological and non-pharmacological treatment options are used,diabetes is still a non-treatable condition.Constant attempts are made to identify newer therapies that could support better management of the diabetes condition and improve overall quality of life.Numerous studies have supported the potential role of probiotics therapy in the diabetes condition.AIM To evaluate the efficacy of triple probiotic combination on glycaemic,metabolic,oxidative stress,and inflammatory parameters in the diabetic population.METHODS Randomized controlled trials evaluating the efficacy of the triple probiotic combination in diabetic patients were identified.The quality of the studies was evaluated using the PEDro scale while biasness between and within the studies was assessed using the Risk of Bias tool.Meta-analysis was conducted using RevMan software,and sensitivity analysis was performed using OpenMeta Analyst software.The study protocol was registered in PROSPERO(CRD42-024530999).RESULTS Five good-quality clinical trials were included.Low-to-moderate risk of bias was observed.Data from 300 participants were included(150 participants in both groups).Probiotics supplementation significantly improved glycaemic and insulin parameters(glucose level:-23.86 mg/dL;insulin level:-5.02μIU/mL;HOMA-IR:-1.82 score;QUICKI:+0.02 score;HOMA-B:-16.30 score;P<0.05 for all parameters),reduced oxidative stress and improved antioxidant parameters[TAC:+92.55 mmol/L;glutathione(GSH):+40.55μmol/L;nitric oxide(NO):+6.45μmol/L;malondialdehyde(MDA):-0.48μmol/L;hs-CRP:-2.24 mg/L;P<0.05 for all parameters except GSH],and improved lipid parameters(total cholesterol(TC):-3.43 mg/dL;triglycerides(TG):-4.26 mg/dL;low-density lipoprotein:-4.62 mg/dL;very low-density lipoprotein:-0.83 mg/dL;high-density lipoprotein(HDL):+1.83 mg/dL;TC/HDL ratio:-0.25;P<0.05 for HDL and TC/HDL ratio parameters)compared to the control group.CONCLUSION The combination of L.acidophilus,L.casei,and B.bifidum is effective in diabetic patients with cardio/renal complications.Further well-designed studies are warranted to support the results of current research.
文摘BACKGROUND There is a need to synthesize the different patterns of fever treatment and phobias in Nigeria and to document these behavioral issues among caregivers.Although,fever is commonly seen in children and this make the mothers to seek medical care when all effort of theirs have failed.Yet,this behavioral and anxiety disorders among mothers still persists several years after the word“Fever phobia”was coined.AIM To document the knowledge of fever among Nigerian mothers and to determine heterogeneity in these practices across the nation.METHODS A search of articles on fever phobias among mothers or caregivers in Nigeria was performed via the Cochrane Database of Systematic Reviews,PubMed,Google Scholar,and MEDLINE.Articles published between 2008,and 2023 were included in the study.The keywords used in the literature search included fever,phobias,perceptions,mothers,caregivers,perceptions,drugs,knowledge,and practices.Boolean operators were also used in the search for items,such as“fever AND phobia”,“fever AND perception”,“fever AND mothers”,“fevers AND/OR phobia”,“AND OR mothers/caregivers”,to help narrow parameters in the search engine and enhance reproducibility.Studies that fulfilled the inclusion criteria were presented via the PRISMA model.I2 statistics were used to assess heterogeneity.RESULTS The studies show wide variation in the reported levels of knowledge about fever,with proportions ranging from as low as 35%to as high as 94%.The pooled proportion estimate using the common effect model is 65%(95%CI:64%-67%),assuming that all studies reflect a single underlying value.However,the random effects model,which accounts for differences among studies,yields a higher estimate of 70%(95%CI:56%-82%).This divergence reflects significant heterogeneity in the data,with a Tau^(2)of 0.7007,I²of 95.7%,and,an H statistic of 4.80,all indicating that most of the variability is due to actual differences among studies rather than random chance.The Q test further confirms this,with a P value less than 0.0001,reinforcing that the variability across studies is statistically significant.The subgroup analysis revealed that studies in Group A(six studies)reported a pooled knowledge proportion of 75%,with a confidence interval ranging from 56%to 88%,and relatively lower heterogeneity(Tau^(2)=0.5709,Tau=0.7556),indicating greater consistency in their findings.In contrast,Group B(four studies)had a lower pooled estimate of 62%,but with a much wider confidence interval(27%to 88%)and greater heterogeneity(Tau^(2)=0.8380,Tau=0.9154),suggesting greater variation across studies in that group.Fear of brain damage,convulsions,witches/wizards,and death was high in many of the studies.Herbal concoctions,and prayers were the mostly used measures to cure fever by mothers.CONCLUSION Mothers’knowledge of fever detection in children is low.There was heterogeneity in the sample size of the studies,which may have affected the knowledge of fever.
文摘Design a precision electroplating mechanical structure for automobiles based on finite element analysis method and analyze its mechanical properties.Taking the automobile steering knuckle as the research object,ABAQUS parametric modeling technology is used to construct its three-dimensional geometric model,and geometric simplification is carried out.Two surface treatment processes,HK-35 zinc nickel alloy electroplating and pure zinc electroplating,were designed,and the influence of different coatings on the mechanical properties of steering knuckles was compared and analyzed through numerical simulation.At the same time,standard specimens were prepared for salt spray corrosion testing and scratch method combined strength testing to verify the numerical simulation results.The results showed that under emergency braking and composite working conditions,the peak Von Mises stress of the zinc nickel alloy coating was 119.85 MPa,which was lower than that of the pure zinc coating and the alkaline electroplated zinc layer.Its equivalent strain value was 652×10^(-6),which was lower than that of the pure zinc coating and the alkaline electroplated zinc layer.Experimental data confirms that zinc nickel alloy coatings exhibit significant advantages in stress distribution uniformity,strain performance,and load-bearing capacity in high stress zones.The salt spray corrosion test further indicates that the coating has superior corrosion resistance and coating substrate interface bonding strength,which can significantly improve the mechanical stability and long-term reliability of automotive precision electroplating mechanical structures.
文摘Background Temporomandibular disorders(TMD)are the leading cause of chronic orofacial pain,which significantly affects patients’quality of life.However,the efficacy of acupuncture in the management of TMD remains unclear.Objective This systematic review aimed to conduct a PRISMA-compliant review to critically assess the therapeutic efficacy of acupuncture as an intervention for patients with TMD.Methods We searched nine electronic databases for randomized controlled trials on acupuncture for TMD published up to February 4,2025.Eligible studies included adults diagnosed with TMD and compared acupuncture(manual,electroacupuncture,warm,auricular,thread-embedding,or laser)with conservative treatment(positive control)or sham acupuncture(negative control).Outcomes included pain intensity,mouth opening,pressure pain threshold,and adverse events.Risk of bias was assessed using ROB 2,and certainty of evidence was evaluated using GRADE.All outcome data were analyzed using RevMan 5.4 software.Low heterogeneity was defined as I^(2)≤50% and P≥0.1,in which case a fixed-effects model was applied.High heterogeneity(I^(2)>50% or P<0.1)prompted further analysis to identify its source.After excluding the influence of evident heterogeneity,a random-effects model was used for the meta-analysis.Results Of the 2664 screened records,14 randomized controlled trials involving 476 participants met the inclusion criteria.Acupuncture significantly reduced pain intensity compared with that of negative controls(MD=-1.75,95%confidence interval[CI]-2.47 to-1.03;P<0.00001;I^(2)=60%)but showed no difference compared with that of positive controls(MD=-0.06,95%CI-0.62 to 0.50;P=0.83;I^(2)=0%).No significant differences were observed in pain-free jaw opening,whereas acupuncture improved maximum mouth opening relative to negative controls(MD=1.80,95%CI 1.62 to 1.97;P<0.00001;I^(2)=0%).For pressure pain threshold,two small studies suggested greater increases with acupuncture.Safety data were limited,with only one trial reporting mild adverse events in the acupuncture group.Conclusion Based on limited evidence,acupuncture appears superior to negative controls in relieving pain associated with TMD but shows no significant advantage over positive controls.The certainty of the evidence for all outcomes,as assessed by GRADE,was low or very low.Therefore,these findings should be interpreted with caution.Future high-quality randomized controlled trials are warranted to further evaluate the role of acupuncture in the management of patients with TMD.
文摘This study presents a systematic review of xu-based studies in an attempt to clarify the construct of the xu-argument and the effectiveness of continuation tasks in foreign language learning.This review adopted a meta-analytic procedure consisting of effect-size aggregation and moderator analysis.While the former quantitatively synthesized evidence in support of xu-based interventions,the latter contextualized evidence in relation to learner and task features.Meta-analytic results indicated a medium-to-large effect of xu-based interventions for foreign language learning(g=1.18 and g=0.49 for within-group and between-group contrasts respectively).This effect was comparatively larger for(a)university-level students,(b)multilingual settings,(c)foreign languages other than English(LOTEs),(d)longer instructional treatments,and(e)specific language features.We interpret supportive evidence for xu-based interventions with respect to theoretical,methodological and pedagogical relevance,and provide empirically grounded recommendations for future task design and research on xu-based practices.
基金financially supported by the National Key R&D Program of China(2022YFF1100600,2022YFF1100605)the Science and Technology Support Program(Modern Agriculture)of Jiangsu Province(BE2022323)the National Natural Science Foundation of China(32302011)。
文摘Resistant starch(RS)has attracted much researchers'attention because of its health-beneficial effects.Gut microbiota obviously shapes human health,but the effects of RS supplementation on the changes of human gut microbiota remain unclear.This observational meta-analysis aimed to reveal the effects of RS intake onα-diversity and composition of gut microbiota through meta-analysis.Two independent authors systematically searched articles from inception until February 2023 on four electronic databases.Twenty-four highly relevant trials were included conforming to Preferred Reporting Items for Systematic reviews and MetaAnalysis protocol,and a total of 816 individuals were included.Significant heterogeneity analyses revealed that RS intake notably decreased Shannon index(weighted mean difference(WMD):-0.11;95%confidence interval(CI):-0.21,-0.01),and stimulated the composition of health promoting bacteria genera,including Bifidobacterium(relative abundance:WMD:1.75;95%CI:0.39,3.11;bacterial populations:WMD:0.36;95%CI:0.04,0.69),Faecalibacterium(relative abundance:WMD:0.70;95%CI:0.20,1.20;fold change:effect size:0.91;95%CI:0.60,1.23),and Prevotella(relative abundance:WMD:0.35;95%CI:0.01,0.69).Taken together,the present study revealed that changes in the gut microbiota diversity and genera were correlated with RS supplementation,which may contribute to benefits in human health.
文摘Objective: To explore the factors affecting the psychological pain of patients with enterostomy through meta-analysis, with the aim of reducing psychological pain and improving patients’ quality of life. Methods: Published literature on psychological pain in enterostomy patients was retrieved from Chinese and English databases, including CNKI, Wanfang, VIP, China Biomedical Network, PubMed, Embase, Ovid, and Web of Science. The search period covered the establishment of the databases until October 2024. Literature was screened based on inclusion and exclusion criteria, and its quality was evaluated. Data analysis was performed using R Studio software. Results: A total of 2,237 articles involving 1,221 patients with enterostomy and 11 influencing factors were identified. The results of the meta-analysis indicated that age, marital status, ostomy complications, self-care ability, pain severity, and sleep quality were the primary contributors to psychological distress. Conclusion: Multiple factors influence psychological pain in enterostomy patients. Medical staff should prioritize addressing these factors to alleviate psychological pain and enhance patients’ quality of life.
基金supported by the National Natural Science Foundation of China(82360801,82460822)Natural Science Foundation of Inner Mongolia Autonomous Region(2022LHQN08001,2023QN08050,2025LHMS08061)+4 种基金the Scientific Research Project of Higher Education Institutions in Inner Mongolia Autonomous Region(NJZY23135)the Laboratory Open Fund of Inner Mongolia Medical University(2024ZN23)and the General Project of Inner Mongolia Medical University(YKD2025MS047Inner Mongolia Medical University Undergraduate Science and Technology Innovation"Talent Cultivation"Project(YCPY2025028,YCPY2025024)Inner Mongolia Medical University Undergraduate Innovation and Entrepreneurship Training Program Project(101322025034).
文摘Background:Bacterial pneumonia continues to be a significant global health concern,particularly among high-risk groups,necessitating the development of precise and early diagnostic biomarkers.While the efficacy of procalcitonin(PCT)and C-reactive protein(CRP)as inflammatory markers is widely recognized,their relative diagnostic performance across different age groups remains debate.This meta-analysis was designed to assess the diagnostic accuracy of PCT and CRP in bacterial pneumonia.Methods:In this meta-analysis adhering to PRISMA guidelines,we searched PubMed,Web of Science,and the Cochrane Library for relevant diagnostic accuracy studies.From 19 included studies(n=2,603),data were extracted to construct tables.Study quality was assessed with the QUADAS-2 tool.The bivariate random-effects model was employed to derive pooled sensitivity,specificity,positive and negative likelihood ratios,and summary AUCs.To explore the substantial heterogeneity(I^(2)>80%),we performed pre-specified subgroup analyses based on age demographics.Results:Our findings indicate superior diagnostic performance for PCT,evidenced by a pooled sensitivity of 0.8841 and specificity of 0.8499,relative to CRP’s sensitivity of 0.8371 and specificity of 0.7185.The area under the ROC curve(AUC)for PCT was 0.992,a value significantly higher than that of CRP(0.987).Intriguingly,subgroup analyses revealed age-dependent variations:CRP demonstrated enhanced diagnostic utility in minors,while PCT proved substantially more effective in non-elderly adults.Conclusion:These results reinforce the clinical relevance of PCT as a more dependable biomarker for bacterial pneumonia,particularly in informing antibiotic treatment and mitigating misuse.This study uniquely includes age-stratified analyses based on predefined groups(minors and non-elderly adults),providing refined insights for individualized diagnostic approaches.We propose further multicenter research endeavors to confirm threshold optimization and explore combined biomarker strategies.
