AIM:To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer(EC)in high-risk areas of China. METHODS:Markov model-based analyses were conducted to compare the net present values(NPVs)and th...AIM:To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer(EC)in high-risk areas of China. METHODS:Markov model-based analyses were conducted to compare the net present values(NPVs)and the benefit-cost ratios(BCRs)of 12 EC endoscopic screening strategies.Strategies varied according to the targeted screening age,screening frequencies,and follow-up intervals.Model parameters were collected from population-based studies in China,published literatures,and surveillance data. RESULTS:Compared with non-screening outcomes,all strategies with hypothetical 100 000 subjects saved life years.Among five dominant strategies determined by the incremental cost-effectiveness analysis,screening once at age 50 years incurred the lowest NPV(international dollar-I$55 million)and BCR(2.52).Screening six times between 40-70 years at a 5-year interval[i.e., six times(40)f-strategy]yielded the highest NPV(I$99 million)and BCR(3.06).Compared with six times(40)fstrategy,screening thrice between 40-70 years at a 10-year interval resulted in relatively lower NPV,but the same BCR. CONCLUSION:EC endoscopic screening is cost-beneficial in high-risk areas of China.Policy-makers should consider the cost-benefit,population acceptance,and local economic status when choosing suitable screening strategies.展开更多
ABSTRACT In year 2000, a book entitled the Pathology and Genetics of Tumors of the Digestive System was published by the WHO, presenting some new diagnostic criteria and treatment principles. I have analyzed the epide...ABSTRACT In year 2000, a book entitled the Pathology and Genetics of Tumors of the Digestive System was published by the WHO, presenting some new diagnostic criteria and treatment principles. I have analyzed the epidemiologic change of tumors in over 30 years in the high-risk area with esophageal cancer. The following phenomenon was found： accompanied by the sharp decrease in the incidence and mortality of esophageal cancer, there was an increase in the incidence and death rate of stomach cancer involving cardiac cancer. This fact should be considered when analyzing the sharp decrease in esophageal cancer incidence and mortality rate. More attention was given to diagnosis of cardiac cancer; at the same time it is more practical to improve the early screening of cancers. To observe the development of high and low - grade intraepithelial neoplasms will be an urgent task for esophageal cancer research in the high risk area, according to WHO＇s new classification.展开更多
Background:Family clustering of esophageal cancer(EC)has been found in high-risk areas of China.However,the relationships between cancer family history and esophageal cancer and precancerous lesions(ECPL)have not been...Background:Family clustering of esophageal cancer(EC)has been found in high-risk areas of China.However,the relationships between cancer family history and esophageal cancer and precancerous lesions(ECPL)have not been comprehensively reported in recent years.This study aimed to provide evidence for identification of high-risk populations.Methods:This study was conducted in five high-risk areas in China from 2017 to 2019,based on the National Cohort of Esophageal Cancer.The permanent residents aged 40 to 69 years were examined by endoscopy,and pathological examination was performed for suspicious lesions.Information on demographic characteristics,environmental factors,and cancer family history was collected.Unconditional logistic regression was applied to evaluate odds ratios between family history related factors and ECPL.Results:Among 33,008 participants,6143(18.61%)reported positive family history of EC.The proportion of positive family history varied significantly among high-risk areas.After adjusting for risk factors,participants with a family history of positive cancer,gastric and esophageal cancer or EC had 1.49-fold(95%confidence interval[CI]:1.36-1.62),1.52-fold(95%CI:1.38-1.67),or 1.66-fold(95%CI:1.50-1.84)higher risks of ECPL,respectively.Participants with single or multiple first-degree relatives(FDR)of positive EC history had 1.65-fold(95%CI:1.47-1.84)or 1.93-fold(95%CI:1.46-2.54)higher risks of ECPL.Participants with FDRs who developed EC before 35,45,and 50 years of age had 4.05-fold(95%CI:1.30-12.65),2.11-fold(95%CI:1.37-3.25),and 1.91-fold(95%CI:1.44-2.54)higher risks of ECPL,respectively.Conclusions:Participants with positive family history of EC had significantly higher risk of ECPL.This risk increased with the number of EC positive FDRs and EC family history of early onset.Distinctive genetic risk factors of the population in high-risk areas of China require further investigation.Trial registration:ChiCTR-EOC-17010553.展开更多
Objective:Given the unique cultural background,way of life,and physical environment of the Tibetan Plateau,this study aims to investigate the effects of health education using problem-based learning(PBL)approaches on ...Objective:Given the unique cultural background,way of life,and physical environment of the Tibetan Plateau,this study aims to investigate the effects of health education using problem-based learning(PBL)approaches on the knowledge,attitude,practice,and coping skills of women with high-risk pregnancies in this region.Methods:76 high-risk pregnancy cases were enrolled at Xizang’s Linzhi People’s Hospital between September 2023 and April 2024.30 patients admitted between September 2023 and December 2023 were selected as the control group and were performed with regular patient education.46 patients admitted between January 2024 and April 2024 were selected as the observation group and were performed regular patient education with problem-based learning approaches.Two groups’performance on their health knowledge,attitude,practice and coping skills before and after interventions were evaluated,and patient satisfaction were measured at the end of the study.Results:There was no statistical significance(P P P Conclusions:Health education with problem-based learning approaches is worth promoting as it can help high-risk pregnant women in plateau areas develop better health knowledge,attitude and practice and healthier coping skills.Also,it can improve patient sanctification.展开更多
The rapid population and land urbanization not only promoted economic development but also affected the ecosystem service value(ESV).In the context of new-type urbanization and green development,it’s essential to inv...The rapid population and land urbanization not only promoted economic development but also affected the ecosystem service value(ESV).In the context of new-type urbanization and green development,it’s essential to investigate the impacts of urbanization on ESV in China.However,a comprehensive and dynamic framework to reveal the relationship between ESV and urbanization processes is lacking.This study adopted multi-source datasets to portray China’s urbanization process by integrating population,land,and economic urbanization,eval-uated the ESV changes of 10 categories by gross ecosystem product(GEP)methods,and explored ESV changes within different urbanization scales and speeds.The results showed rapid urbanization in the population,land,and economic dimensions in China,with a faster process of economic urbanization.The ESV also exhibited an increasing trend,with higher levels in the southeastern coastal regions and lower levels in the northwestern regions.Urbanization had positive impacts on ESV across various research units,but the ESV exhibited heteroge-neous changes across different urbanization scales,speeds,and their interactive effects.The response of ESV to dynamic urbanization processes was influenced by socio-economic,ecological,and policy factors;it is essential to combine targeted measures with general ecological product value realization methods in each unit to maximize social-economic-ecological benefits.展开更多
BACKGROUND Effective health management for high-risk stroke populations is essential.The hospital-community-home(HCH)collaborative health management(CHM)model leverages resources from hospitals,communities,and familie...BACKGROUND Effective health management for high-risk stroke populations is essential.The hospital-community-home(HCH)collaborative health management(CHM)model leverages resources from hospitals,communities,and families.By integrating patient information across these three domains,it facilitates the delivery of tailored guidance,health risk assessments,and three-in-one health education.AIM To explore the effects of the HCH-CHM model on stroke risk reduction in highrisk populations.METHODS In total,110 high-risk stroke patients screened in the community from January 2019 to January 2023 were enrolled,with 52 patients in the control group receiving routine health education and 58 in the observation group receiving HCH-CHM model interventions based on routine health education.Stroke awareness scores,health behavior levels,medication adherence,blood pressure,serum biochemical markers(systolic/diastolic blood pressure,total cholesterol,and triglyceride),and psychological measures(self-rating anxiety/depression scale)were evaluated and compared between groups.RESULTS The observation group showed statistically significant improvements in stroke awareness scores and health behavior levels compared to the control group(P<0.05),with notable enhancements in lifestyle and dietary habits(P<0.05)and reductions in postintervention systolic blood pressure,diastolic blood pressure,total cholesterol,triglyceride,self-rating anxiety scale,and self-rating depression scale scores(P<0.05).CONCLUSION The HCH-CHM model had a significant positive effect on high-risk stroke populations,effectively increasing disease awareness,improving health behavior and medication adherence,and appropriately ameliorating blood pressure,serum biochemical marker levels,and negative psychological symptoms.展开更多
Objective: To study the clinical effect and safety of the the bleeding after cesarean section in high-risk pregnant women. Methods: 117 high-risk pregnant women undergoing cesarean section were the subject of this exp...Objective: To study the clinical effect and safety of the the bleeding after cesarean section in high-risk pregnant women. Methods: 117 high-risk pregnant women undergoing cesarean section were the subject of this experimental study, starting from October 2020 and ending in October 2021. The study of 117 patients according to the patients receiving treatment will be divided into C, D, E three groups, each group of patients have 39 cases, the given in group C patients carprostamine combined with oxytocin therapy, give group D patients carprostamine plug with hystercin therapy, group E is a single oxytocin treatment. Results: Comparison of intraoperative bleeding, 2 hours after, and 2-24 hours in the three groups, In Group C, For the three groups, p <0.05, However, the comparison between the D and E groups was not significantly different and different, p>0.05;in addition, The rates of blood transfusion, postpartum bleeding and assisted hemostasis interventions in the three groups were also the lowest in group C, By contrast: p <0.05, In addition, the comparison between the D and E groups was not significantly different, p>0.05;besides, The comparison between groups C, D, and E was not significantly different in the incidence of adverse reactions such as fever, diarrhea, elevated blood pressure, vomiting, and nausea, P>0.05. The clinical efficacy of group C was higher than that of group D and E (P <0.05), and there was no difference in the clinical efficacy between group D and E (P> 0.05). Compared with group D and E, group C had shorter hemostasis duration and longer contractions in group C (P <0.05), and no difference between the above indicators between group D and E (P> 0.05). Before the operation three groups of each coagulation index, hematocrit, please give you, hemoglobin levels, red blood cell technology is not significantly different, p> 0.05, however, after the three groups of surgery, it is clear that the group C patients index is better than group D and E patients, the three groups of p <0.05, group D, E each coagulation index is no difference (P> 0.05). Conclusion: The treatment of carprosterambutriol combined with oxytocin in high-risk pregnant women undergoing cesarean section can not only reduce the incidence of postpartum bleeding and improve the clinical effect, but also actively improve the coagulation function index and improve the hemoglobin level, red blood cell count and hematocrit.展开更多
Understanding the levels,causes,and sources of fluoride in groundwater is critical for public health,effective water resource management,and sustainable utilization.This study employs multivariate statistical methods,...Understanding the levels,causes,and sources of fluoride in groundwater is critical for public health,effective water resource management,and sustainable utilization.This study employs multivariate statistical methods,hazard quotient assessment,and geochemical analyses,such as mineral saturation index,ionic activities,and Gibbs diagrams,to investigate the hydrochemical characteristics,causes,and noncarcinogenic risks of fluoride in Red bed groundwater and geothermal water in the Guang'an area and neighboring regions.Approximately 9%of the Red bed groundwater samples contain fluoride concentrations exceeding 1 mg·L^(-1).The predominant water types identified are Cl-Na and HCO_(3)-Na,primarily influenced by evapotranspiration.Low-fluoride groundwater and high-fluoride geothermal water exhibit distinct hydrochemical types HCO_(3)-Ca and SO_(4)-Ca,respectively,which are mainly related to the weathering of carbonate,sulfate,and fluorite-containing rocks.Correlation analysis reveals that fluoride content in Red bed groundwater is positively associated with Na^(+),Cl^(-),SO_(4)^(2-),and TDS(r^(2)=0.45-0.64,p<0.01),while in geothermal water,it correlates strongly with pH,K^(+),Ca^(2+),and Mg^(2+)(r^(2)=0.52-0.80,p<0.05).Mineral saturation indices and ionic activities indicate that ion exchange processes and the dissolution of minerals such as carbonatite and fluorite are important sources of fluoride in groundwater.The enrichment of fluorine in the Red bed groundwater is linked to evaporation,cation exchange and dissolution of fluorite,caused by the lithologic characteristics of the red bed in this area.However,it exhibits minimal correlation with the geothermal water in the adjacent area.The noncarcinogenic health risk assessment indicates that 7%(n=5)of Red bed groundwater points exceed the fluoride safety limit for adults,while 12%(n=8)exceed the limit for children.These findings underscore the importance of avoiding highly fluoridated red bed groundwater as a direct drinking source and enhancing groundwater monitoring to mitigate health risks associated with elevated fluoride levels.展开更多
Based on comprehensive observations of 20 wire icing events during winter from 2019 to 2021,we investigated the characteristics of the icing properties,the atmospheric boundary layer structure,the raindrop size distri...Based on comprehensive observations of 20 wire icing events during winter from 2019 to 2021,we investigated the characteristics of the icing properties,the atmospheric boundary layer structure,the raindrop size distribution,and their associated effects on the ice accretion mechanism in the mountainous region of Southwest China.The maximum ice weight was positively correlated with the duration of ice accretion in the mountainous area.The duration of precipitation accounted for less than 20%of the icing period in the mountainous area,with solid-phase hydrometeors being predominant.Icing events,dominated by freezing rain(FR)and mixed rain–graupel(more than 70%),were characterized by glaze or highdensity mixed icing.The relationship between the melting energy and refreezing energy reflected the distribution characteristics of the proportion of FR under mixed-phase precipitation.The intensity of the warm layer and the dominant precipitation phase significantly affected the variations in the microphysical properties of FR.The melting of large dry snowflakes significantly contributed to FR in the mountainous areas,resulting in smaller generalized intercepts and larger mass-weighted mean diameters in the presence of a stronger warm layer.Under a weaker warm layer,the value of the massweighted mean diameter was significantly smaller because of the inability of large solid particles to melt.Finally,FR in the mountainous area dominated the ice weight during the rapid ice accumulation period.A numerical simulation of FR icing on wires effectively revealed the evolution of disaster-causing icing in mountainous areas.展开更多
RBOE is a new type of DNAN-based high-energy melt-cast mixed explosive,whose safety under thermal stimulation is significantly affected by heating conditions and venting area of the warhead.Based on the thermal decomp...RBOE is a new type of DNAN-based high-energy melt-cast mixed explosive,whose safety under thermal stimulation is significantly affected by heating conditions and venting area of the warhead.Based on the thermal decomposition reaction characteristics and combustion characteristics of each component of RBOE explosive,the cook-off calculation models of RBOE warhead before and after ignition were established.In addition,closed and vented warheads were designed,as well as fast and slow cook-off test devices.The cook-off characteristics and thermal safety venting area of RBOE warhead were extensively studied.The results showed that the closed RBOE warhead underwent deflagration reaction under both slow and fast cook-off conditions.The calculation result of the shell wall temperature before slow cookoff ignition response of the warhead was 454.06 K,with an error of+1.75%compared to the test result of462.15 K,and the temperature rise rate calculated was in good agreement with the test.The calculated ignition time of RBOE warhead under fast cook-off was 161 s,with an error of+8.8%compared to the test result of 148 s,which verified the accuracy of cook-off model of RBOE warhead before ignition.According to the cook-off calculation model of the warhead after ignition and cook-off test of the vented warhead,it was determined that the thermal safety venting area was 1124.61 mm^(2)for fast cook-off and 530.66 mm~2 for slow cook-off,effectively preventing the reaction of warhead above combustion.Therefore,this study provides a scientific basis for the thermal safety design and evaluation of insensitive warheads.展开更多
Phthalic acid esters(PAEs)are a group of compounds widespread in the environment.To investigate the occurrence and accumulation characteristics of PAEs,surface water samples were collected from the Three Gorges Reserv...Phthalic acid esters(PAEs)are a group of compounds widespread in the environment.To investigate the occurrence and accumulation characteristics of PAEs,surface water samples were collected from the Three Gorges Reservoir area,China.The total concentrations of∑_(11)analyzed PAEs(11PAEs)in the collected water samples ranging from 197.7 to 1,409.3 ng/L(mean±IQR:583.1±308.4 ng/L).While DEHP was the most frequently detected PAE,DnBP and DnNP were the most predominant PAEs in the analyzed water samples with a mean contribution of 63.3%of the∑_(11)PAEs.The concentrations of the∑_(11)PAEs in the water samples from the upper reaches of the Yangtze River were significantly higher than those from themiddle reaches.To better understand the transport and fate of the PAEs,seven detected PAEs were modeled by Quantitative Water Air Sediment Interaction(QWASI).The simulated and measured values were close for most PAEs,and differences are within one order of magnitude even for the worst one.For all simulated PAEs,water and particle inflow were main sources in the reservoir,whereas water outflow and degradation in water were important removal pathways.The contribution ratios of different sources/losses varied fromPAEs,depending on their properties.The calculated risk quotients of DnNP in the Three Gorges Reservoir area whether based onmonitoring or simulating results were all far exceeded the safety threshold value,implying the occurrence of this PAE compound may cause potential adverse effects for the aquatic ecology of the Three Gorges Reservoir area.展开更多
Soil moisture(SM)is a critical variable in terrestrial ecosystems,especially in arid and semi-arid areas where water sources are limited.Despite its importance,understanding the spatiotemporal variations and influenci...Soil moisture(SM)is a critical variable in terrestrial ecosystems,especially in arid and semi-arid areas where water sources are limited.Despite its importance,understanding the spatiotemporal variations and influencing factors of SM in these areas remains insufficient.This study investigated the spatiotemporal variations and influencing factors of SM in arid and semi-arid areas of China by utilizing the extended triple collation(ETC),Mann-Kendall test,Theil-Sen estimator,ridge regression analysis,and other relevant methods.The following findings were obtained:(1)at the pixel scale,the long-term monthly SM data from the European Space Agency Climate Change Initiative(ESA CCI)exhibited the highest correlation coefficient of 0.794 and the lowest root mean square error(RMSE)of 0.014 m^(3)/m^(3);(2)from 2000 to 2022,the study area experienced significant increase in annual average SM,with a rate of 0.408×10^(-3)m^(3)/(m^(3)•a).Moreover,higher altitudes showed a notable upward trend,with SM increasing rates at 0.210×10^(-3)m^(3)/(m^(3)•a)between 1000 and 2000 m,0.530×10^(-3)m^(3)/(m^(3)•a)between 2000 and 4000 m,and 0.760×10^(-3)m^(3)/(m^(3)•a)at altitudes above 4000 m;(3)land surface temperature(LST),root zone soil moisture(RSM)(10-40 cm depth),and normalized difference vegetation index(NDVI)were identified as the primary factors influencing annual average SM,which accounted for 34.37%,24.16%,and 22.64%relative contributions,respectively;and(4)absolute contribution of LST was more significant in subareas at higher altitudes,with average absolute contributions of 0.800×10^(-3)m^(3)/(m^(3)•a)between 2000 and 4000 m and 0.500×10^(-2) m^(3)/(m^(3)•a)above 4000 m.This study reveals the spatiotemporal variations and main influencing factors of SM in Chinese arid and semi-arid areas,highlighting the more pronounced absolute contribution of LST to SM in high-altitude areas,providing valuable insights for ecological research and water resource management in these areas.展开更多
Objective: Stroke is perceived as a serious illness although it is preventable, and lifestyle alterations can be made to reduce its risk. Improvement of stroke care should be achieved through awareness of public, espe...Objective: Stroke is perceived as a serious illness although it is preventable, and lifestyle alterations can be made to reduce its risk. Improvement of stroke care should be achieved through awareness of public, especially through high-risk group. Henceforth, the aim of this study was to evaluate the effect of nursing intervention on improving awareness of high-risk people about stroke prevention. Methods: A quasi-experimental design was used to carry out this study, where a purposive sample of 80 adult patients at high risk for stroke were enrolled while they were attending the out-patient clinics of Zagazig University Hospitals for follow-up treatment;they were divided into two groups: case (40 patients) and control (40 patients). An interview questionnaire was used to assess patients’ knowledge regarding warning signs, risk factors, and immediate treatment;attitude;and their practice for prevention for stroke at pretest and posttest. Results: The study revealed the poor level of knowledge, bad level of preventive behavior, and negative attitude regarding stroke prevention at pre-intervention. However, after intervention, the high-risk people had fair level of knowledge with moderate practice for stroke prevention and positive attitude, with statistically significant difference between pre-post intervention and between the case and control groups. Conclusions: The study revealed that the nursing intervention seemed to change the knowledge, practice, and attitude of subjects regarding stroke prevention. This, in turn, implies that awareness of prevention of stroke and high-risk factor control could be important to reduce the burden of stroke in Egypt. Thus, further research on a larger scale is required to improve population knowledge and behavior for stroke prevention and control.展开更多
Objective:To explore the perspectives of high-risk pregnant women regarding the home care program for high-risk pregnancies.Methods:This qualitative study was conducted in a university hospital and 5 comprehensive hea...Objective:To explore the perspectives of high-risk pregnant women regarding the home care program for high-risk pregnancies.Methods:This qualitative study was conducted in a university hospital and 5 comprehensive health centers in Ahvaz,Iran,from February 2023 to July 2023.The sampling method used was purposive sampling considering the maximum possible diversity,which continued until data saturation.11 in-depth and semistructured interviews were conducted with high-risk pregnant women.Data were simultaneously analysed using Graneheim and Lundman content analysis by MAXQDA version 20 software.Results:Data analysis extracted 3 themes,12 categories,and 26 subcategories.The themes and categories were“high-risk pregnancy and related issues(pursuing treatment and paying attention to the high-risk situation by pregnant women,psychological aspect of high-risk pregnancy on pregnant women and caregivers,emotional and physical aspects of high-risk pregnancy,the consequences of high-risk pregnancy on the people around them and empowerment of high-risk pregnant women)”,“support dimension(family and community support for high-risk pregnant women)”,and“framework of program(acculturalization,means and equipment,security,manpower and the necessary arrangements for the home care)”.Conclusions:High-risk pregnancy affects various aspects of the lives of high-risk pregnant women and their families.Creating the necessary conditions for providing care at home plays a vital role in supporting high-risk pregnant women and removing related obstacles to receiving prenatal care in person.It will be especially beneficial for high-risk pregnant women in low-income areas.展开更多
In Niger, irrigated agriculture constitutes the main alternative for meeting family needs. It is within this framework that the state and its partners have adopted strategies to promote irrigated production sites. Thi...In Niger, irrigated agriculture constitutes the main alternative for meeting family needs. It is within this framework that the state and its partners have adopted strategies to promote irrigated production sites. This study was carried out on the Konni irrigated perimeter, the objective of which is to analyze the physical state of hydraulic infrastructures and their operation before the rehabilitation of the said perimeter. The methodology adopted consisted, first of all, of documentary research focused on data relating to this scope and our theme to properly guide the collection of data in the field. The field phase was then followed with an observation of hydraulic infrastructures one by one in order to assess their condition. Thus, the collected data was processed and analyzed. The results of this study show a notable deterioration of hydraulic infrastructure which affected the operating yield of the study area, with the development of barely 700 ha out of 1226 ha planned by the basic study for off-season production (57%). Bathymetric measurements showed that the volume of sediment that accumulated in the Zongo Dam is 1.2 million m3, which reduces its initial capacity from 12 million m3 to 10.8 million m3 after 43 years of service. The expansion joints of the feed canal are all in poor condition. 90% of the total length of the tertiary canals are degraded, 82.32% of the panels of the main canal C are degraded and 17.68% are cracked. All crossing structures are blocked between the RN1 and the Zongo dam. Based on this critical situation, it would be essential to consider rehabilitation work on all infrastructure in order to restore the hydraulic and even agronomic performance of the Konni irrigated area.展开更多
Models that predict a forest stand’s evolution are essential for developing plans for sustainable management.A simple mathematical framework was developed that con-siders the individual tree and stand basal area unde...Models that predict a forest stand’s evolution are essential for developing plans for sustainable management.A simple mathematical framework was developed that con-siders the individual tree and stand basal area under random resource competition and is based on two assumptions:(1)a sigmoid-type stochastic process governs tree and stand basal area dynamics of living and dying trees,and(2)the total area that a tree may potentially occupy determines the number of trees per hectare.The most effective method to satisfy these requirements is formalizing each tree diameter and potentially occupied area using Gompertz-type stochastic differential equations governed by fixed and mixed-effect parameters.Data from permanent experimental plots from long-term Lithuania experiments were used to construct the tree and stand basal area models.The new models were relatively unbiased for live trees of all species,including silver birch(Betula pen-dula Roth)and downy birch(Betula pubescens Ehrh.),[spruce(Picea abies),and pine(Pinus sylvestris)].Less reliable predic-tions were made for the basal area of dying trees.Pines gave the highest accuracy prediction of mean basal area among all live trees.The mean basal area prediction for all dying trees was lower than that for live trees.Among all species,pine also had the best average basal area prediction accuracy for live trees.Newly developed basal area growth and yield models can be recommended despite their complex formulation and implementation challenges,particularly in situations when data is scarce.This is because the newly observed plot provides sufficient information to calibrate random effects.展开更多
Background:Loneliness is a common experience for pregnant women and correlates with perinatal depression and negative pregnancy outcomes.Women experiencing a high-risk pregnancy are at greater risk for loneliness beca...Background:Loneliness is a common experience for pregnant women and correlates with perinatal depression and negative pregnancy outcomes.Women experiencing a high-risk pregnancy are at greater risk for loneliness because of uncertainty with disease and the medicalization of pregnancy.International studies have identified an association between perceived stress and loneliness in pregnant women.The aim of this study is to explore factors related to loneliness among women of high-risk pregnancy,and to examine the associated relationship of loneliness and perceived stress.Methods:Using convenience sampling,109 women with high-risk pregnancies were enrolled.Data collection involved questionnaires on general demographic characteristics,the 6-item Loneliness Scale(ULS-6),and the Chinese version of the Perceived Stress Scale(CPSS-14).Data analysis was performed using SPSS 28.0 statistical software.Results:The mean loneliness score was 9.95±2.99,and the mean perceived stress score was 22.84±5.80.Women with high-risk pregnancies exhibited statistically significant differences in loneliness scores compared to the control group across among age,marital status,educational attainment,per capita monthly household income,spousal relationship,in-law relationship,and parental relationship(P<0.05).Correlation analysis revealed a positive correlation between loneliness and perceived stress(r=0.456,P<0.01).Multivariate regression analysis indicated that per capita monthly household income,marital relationship,in-law relationship,and perceived stress were the primary factors influencing loneliness among women with high-risk pregnancies(P<0.05).Conclusion:The results highlight the need for specific interventions addressing loneliness among women with high-risk pregnancies.Such interventions should focus on improving spousal and in-law relationships,reducing perceived stress,and implementing support measures,such as financial counseling or assistance programs,for those with lower per capita household income.This study establishes a foundation for the creation of integrated support systems that bring together families and healthcare providers to strengthen maternal mental health.展开更多
Objective:Our previous studies have indicated potentially higher proliferative activity of tumor cells in Chinese patients with mantle-cell lymphoma(MCL)than those in Western.Given the success and tolerability of R-DA...Objective:Our previous studies have indicated potentially higher proliferative activity of tumor cells in Chinese patients with mantle-cell lymphoma(MCL)than those in Western.Given the success and tolerability of R-DA-EDOCH immunochemotherapy in treating aggressive B-cell lymphomas,we designed a prospective,phase 3 trial to explore the efficacy and safety of alternating R-DA-EDOCH/R-DHAP induction therapy for young patients with newly diagnosed MCL.The primary endpoint was the complete remission rate(CRR)at the end of induction(EOI).Methods:A total of 55 patients were enrolled.The CRR at the EOI was 89.1%[95%confidence interval(CI)78%±96%],and the overall response rate was 98.1%(95%CI 90%±100%).Most patients with bone marrow involvement quickly attained minimal residual disease(MRD)negative status,with a 95.7%rate at the EOI.Results:The 3-year progression-free survival(PFS)and overall survival rates were 66.3%and 83.2%,respectively.No patients discontinued treatment because of adverse events.Univariate analysis identified pathologic morphology and TP53 mutations as risk factors for PFS.However,high tumor proliferative activity and certain cytogenetic abnormalities showed no significant adverse prognostic significance.Conclusions:Intensive therapy based on a high cytarabine dose and continuously administered EDOCH achieved a high MRDnegative rate and provides an optional induction choice for young patients with MCL with high-risk factors.展开更多
Pregnant women with high-risk pregnancy face a higher risk of complications due to factors such as chronic diseases,multiple pregnancies,and a history of adverse pregnancy and childbirth,requiring more systematic and ...Pregnant women with high-risk pregnancy face a higher risk of complications due to factors such as chronic diseases,multiple pregnancies,and a history of adverse pregnancy and childbirth,requiring more systematic and dynamic health management support.In view of this,“Internet+continuous nursing”can break the limitations of time and space by integrating mobile communication,remote monitoring,data sharing,and intelligent analysis technologies,realizing closed-loop care with collaboration among hospitals,communities,and families.Research shows that continuous nursing based on the“Internet+”significantly improves the professional response ability of caregivers.Medical staff can grasp the patient’s status in real time,optimize diagnosis and treatment decisions,providing a feasible path for building an efficient,precise,and humanized high-risk pregnancy management system,which has broad clinical promotion value and public health significance.展开更多
While numerous allometric models exist for estimating biomass in trees with single stems,models for multi-stemmed species are scarce.This study presents models for predicting aboveground biomass(AGB)in European hazel(...While numerous allometric models exist for estimating biomass in trees with single stems,models for multi-stemmed species are scarce.This study presents models for predicting aboveground biomass(AGB)in European hazel(Corylus avellana L.),growing in multi-stemmed shrub form.We measured the size and harvested the biomass of 30 European hazel shrubs,drying and weighing their woody parts and leaves separately.AGB(dry mass)and leaf area models were established using a range of predictors,such as the upper height of the shrub,number of shoots per shrub,canopy projection area,stem base diameter of the thickest stem,and the sum of cross-sectional areas of all stems at the stem base.The latter was the best predictor of AGB,but the most practically useful variables,defined as relatively easy to measure by terrestrial or aerial approaches,were the upper height of the shrub and the canopy projection area.The leaf biomass to AGB ratio decreased with the shrub's height.Specific leaf area of shaded leaves increases with shrub height,but that of leaves at the top of the canopy does not change significantly.Given that the upper shrub height and crown projection of European hazel can be estimated using remote sensing approaches,especially UAV and LIDAR,these two variables appear the most promising for effective measurement of AGB in hazel.展开更多
基金Supported by The National Science and Technology Pillar Program of the 11th National Five-Year Plan of China,No. 2006BAI02A15
文摘AIM:To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer(EC)in high-risk areas of China. METHODS:Markov model-based analyses were conducted to compare the net present values(NPVs)and the benefit-cost ratios(BCRs)of 12 EC endoscopic screening strategies.Strategies varied according to the targeted screening age,screening frequencies,and follow-up intervals.Model parameters were collected from population-based studies in China,published literatures,and surveillance data. RESULTS:Compared with non-screening outcomes,all strategies with hypothetical 100 000 subjects saved life years.Among five dominant strategies determined by the incremental cost-effectiveness analysis,screening once at age 50 years incurred the lowest NPV(international dollar-I$55 million)and BCR(2.52).Screening six times between 40-70 years at a 5-year interval[i.e., six times(40)f-strategy]yielded the highest NPV(I$99 million)and BCR(3.06).Compared with six times(40)fstrategy,screening thrice between 40-70 years at a 10-year interval resulted in relatively lower NPV,but the same BCR. CONCLUSION:EC endoscopic screening is cost-beneficial in high-risk areas of China.Policy-makers should consider the cost-benefit,population acceptance,and local economic status when choosing suitable screening strategies.
文摘ABSTRACT In year 2000, a book entitled the Pathology and Genetics of Tumors of the Digestive System was published by the WHO, presenting some new diagnostic criteria and treatment principles. I have analyzed the epidemiologic change of tumors in over 30 years in the high-risk area with esophageal cancer. The following phenomenon was found： accompanied by the sharp decrease in the incidence and mortality of esophageal cancer, there was an increase in the incidence and death rate of stomach cancer involving cardiac cancer. This fact should be considered when analyzing the sharp decrease in esophageal cancer incidence and mortality rate. More attention was given to diagnosis of cardiac cancer; at the same time it is more practical to improve the early screening of cancers. To observe the development of high and low - grade intraepithelial neoplasms will be an urgent task for esophageal cancer research in the high risk area, according to WHO＇s new classification.
基金National Natural Science Foundation of China(Nos.81903402,81974493)the National Key R&D Program of China(Nos.2016YFC0901404,2018YFC1311704)the Chinese Academic of Medical Sciences Innovation Fund for Medical Sciences(No.2019-I2M-2-004)。
文摘Background:Family clustering of esophageal cancer(EC)has been found in high-risk areas of China.However,the relationships between cancer family history and esophageal cancer and precancerous lesions(ECPL)have not been comprehensively reported in recent years.This study aimed to provide evidence for identification of high-risk populations.Methods:This study was conducted in five high-risk areas in China from 2017 to 2019,based on the National Cohort of Esophageal Cancer.The permanent residents aged 40 to 69 years were examined by endoscopy,and pathological examination was performed for suspicious lesions.Information on demographic characteristics,environmental factors,and cancer family history was collected.Unconditional logistic regression was applied to evaluate odds ratios between family history related factors and ECPL.Results:Among 33,008 participants,6143(18.61%)reported positive family history of EC.The proportion of positive family history varied significantly among high-risk areas.After adjusting for risk factors,participants with a family history of positive cancer,gastric and esophageal cancer or EC had 1.49-fold(95%confidence interval[CI]:1.36-1.62),1.52-fold(95%CI:1.38-1.67),or 1.66-fold(95%CI:1.50-1.84)higher risks of ECPL,respectively.Participants with single or multiple first-degree relatives(FDR)of positive EC history had 1.65-fold(95%CI:1.47-1.84)or 1.93-fold(95%CI:1.46-2.54)higher risks of ECPL.Participants with FDRs who developed EC before 35,45,and 50 years of age had 4.05-fold(95%CI:1.30-12.65),2.11-fold(95%CI:1.37-3.25),and 1.91-fold(95%CI:1.44-2.54)higher risks of ECPL,respectively.Conclusions:Participants with positive family history of EC had significantly higher risk of ECPL.This risk increased with the number of EC positive FDRs and EC family history of early onset.Distinctive genetic risk factors of the population in high-risk areas of China require further investigation.Trial registration:ChiCTR-EOC-17010553.
基金Leading Specialist Construction Project-Department of the First Affiliated Hospital,Jinan University(2022225).
文摘Objective:Given the unique cultural background,way of life,and physical environment of the Tibetan Plateau,this study aims to investigate the effects of health education using problem-based learning(PBL)approaches on the knowledge,attitude,practice,and coping skills of women with high-risk pregnancies in this region.Methods:76 high-risk pregnancy cases were enrolled at Xizang’s Linzhi People’s Hospital between September 2023 and April 2024.30 patients admitted between September 2023 and December 2023 were selected as the control group and were performed with regular patient education.46 patients admitted between January 2024 and April 2024 were selected as the observation group and were performed regular patient education with problem-based learning approaches.Two groups’performance on their health knowledge,attitude,practice and coping skills before and after interventions were evaluated,and patient satisfaction were measured at the end of the study.Results:There was no statistical significance(P P P Conclusions:Health education with problem-based learning approaches is worth promoting as it can help high-risk pregnant women in plateau areas develop better health knowledge,attitude and practice and healthier coping skills.Also,it can improve patient sanctification.
基金supported by the Key Program of the National Natural Science Foundation of China(Grant No.41931293)the National Natural Science Foundation of China(Grant No.42271275).
文摘The rapid population and land urbanization not only promoted economic development but also affected the ecosystem service value(ESV).In the context of new-type urbanization and green development,it’s essential to investigate the impacts of urbanization on ESV in China.However,a comprehensive and dynamic framework to reveal the relationship between ESV and urbanization processes is lacking.This study adopted multi-source datasets to portray China’s urbanization process by integrating population,land,and economic urbanization,eval-uated the ESV changes of 10 categories by gross ecosystem product(GEP)methods,and explored ESV changes within different urbanization scales and speeds.The results showed rapid urbanization in the population,land,and economic dimensions in China,with a faster process of economic urbanization.The ESV also exhibited an increasing trend,with higher levels in the southeastern coastal regions and lower levels in the northwestern regions.Urbanization had positive impacts on ESV across various research units,but the ESV exhibited heteroge-neous changes across different urbanization scales,speeds,and their interactive effects.The response of ESV to dynamic urbanization processes was influenced by socio-economic,ecological,and policy factors;it is essential to combine targeted measures with general ecological product value realization methods in each unit to maximize social-economic-ecological benefits.
基金Supported by Guiding Project of Hebei Provincial Health Commission,No.20201190 and 20180220.
文摘BACKGROUND Effective health management for high-risk stroke populations is essential.The hospital-community-home(HCH)collaborative health management(CHM)model leverages resources from hospitals,communities,and families.By integrating patient information across these three domains,it facilitates the delivery of tailored guidance,health risk assessments,and three-in-one health education.AIM To explore the effects of the HCH-CHM model on stroke risk reduction in highrisk populations.METHODS In total,110 high-risk stroke patients screened in the community from January 2019 to January 2023 were enrolled,with 52 patients in the control group receiving routine health education and 58 in the observation group receiving HCH-CHM model interventions based on routine health education.Stroke awareness scores,health behavior levels,medication adherence,blood pressure,serum biochemical markers(systolic/diastolic blood pressure,total cholesterol,and triglyceride),and psychological measures(self-rating anxiety/depression scale)were evaluated and compared between groups.RESULTS The observation group showed statistically significant improvements in stroke awareness scores and health behavior levels compared to the control group(P<0.05),with notable enhancements in lifestyle and dietary habits(P<0.05)and reductions in postintervention systolic blood pressure,diastolic blood pressure,total cholesterol,triglyceride,self-rating anxiety scale,and self-rating depression scale scores(P<0.05).CONCLUSION The HCH-CHM model had a significant positive effect on high-risk stroke populations,effectively increasing disease awareness,improving health behavior and medication adherence,and appropriately ameliorating blood pressure,serum biochemical marker levels,and negative psychological symptoms.
文摘Objective: To study the clinical effect and safety of the the bleeding after cesarean section in high-risk pregnant women. Methods: 117 high-risk pregnant women undergoing cesarean section were the subject of this experimental study, starting from October 2020 and ending in October 2021. The study of 117 patients according to the patients receiving treatment will be divided into C, D, E three groups, each group of patients have 39 cases, the given in group C patients carprostamine combined with oxytocin therapy, give group D patients carprostamine plug with hystercin therapy, group E is a single oxytocin treatment. Results: Comparison of intraoperative bleeding, 2 hours after, and 2-24 hours in the three groups, In Group C, For the three groups, p <0.05, However, the comparison between the D and E groups was not significantly different and different, p>0.05;in addition, The rates of blood transfusion, postpartum bleeding and assisted hemostasis interventions in the three groups were also the lowest in group C, By contrast: p <0.05, In addition, the comparison between the D and E groups was not significantly different, p>0.05;besides, The comparison between groups C, D, and E was not significantly different in the incidence of adverse reactions such as fever, diarrhea, elevated blood pressure, vomiting, and nausea, P>0.05. The clinical efficacy of group C was higher than that of group D and E (P <0.05), and there was no difference in the clinical efficacy between group D and E (P> 0.05). Compared with group D and E, group C had shorter hemostasis duration and longer contractions in group C (P <0.05), and no difference between the above indicators between group D and E (P> 0.05). Before the operation three groups of each coagulation index, hematocrit, please give you, hemoglobin levels, red blood cell technology is not significantly different, p> 0.05, however, after the three groups of surgery, it is clear that the group C patients index is better than group D and E patients, the three groups of p <0.05, group D, E each coagulation index is no difference (P> 0.05). Conclusion: The treatment of carprosterambutriol combined with oxytocin in high-risk pregnant women undergoing cesarean section can not only reduce the incidence of postpartum bleeding and improve the clinical effect, but also actively improve the coagulation function index and improve the hemoglobin level, red blood cell count and hematocrit.
基金supported by the China Geological Survey Project(Nos.DD20220864 and DD20243077).
文摘Understanding the levels,causes,and sources of fluoride in groundwater is critical for public health,effective water resource management,and sustainable utilization.This study employs multivariate statistical methods,hazard quotient assessment,and geochemical analyses,such as mineral saturation index,ionic activities,and Gibbs diagrams,to investigate the hydrochemical characteristics,causes,and noncarcinogenic risks of fluoride in Red bed groundwater and geothermal water in the Guang'an area and neighboring regions.Approximately 9%of the Red bed groundwater samples contain fluoride concentrations exceeding 1 mg·L^(-1).The predominant water types identified are Cl-Na and HCO_(3)-Na,primarily influenced by evapotranspiration.Low-fluoride groundwater and high-fluoride geothermal water exhibit distinct hydrochemical types HCO_(3)-Ca and SO_(4)-Ca,respectively,which are mainly related to the weathering of carbonate,sulfate,and fluorite-containing rocks.Correlation analysis reveals that fluoride content in Red bed groundwater is positively associated with Na^(+),Cl^(-),SO_(4)^(2-),and TDS(r^(2)=0.45-0.64,p<0.01),while in geothermal water,it correlates strongly with pH,K^(+),Ca^(2+),and Mg^(2+)(r^(2)=0.52-0.80,p<0.05).Mineral saturation indices and ionic activities indicate that ion exchange processes and the dissolution of minerals such as carbonatite and fluorite are important sources of fluoride in groundwater.The enrichment of fluorine in the Red bed groundwater is linked to evaporation,cation exchange and dissolution of fluorite,caused by the lithologic characteristics of the red bed in this area.However,it exhibits minimal correlation with the geothermal water in the adjacent area.The noncarcinogenic health risk assessment indicates that 7%(n=5)of Red bed groundwater points exceed the fluoride safety limit for adults,while 12%(n=8)exceed the limit for children.These findings underscore the importance of avoiding highly fluoridated red bed groundwater as a direct drinking source and enhancing groundwater monitoring to mitigate health risks associated with elevated fluoride levels.
基金funded by the National Natural Science Foundation of China(Grant No.42325503)the Hubei Provincial Natural Science Foundation and the Meteorological Innovation and Development Project of China(Grant Nos.2023AFD096 and 2022CFD122)+1 种基金the Natural Science Foundation of Wuhan(Grant No.2024020901030454)the Beijige Foundation of NJIAS(Grant No.BJG202304)。
文摘Based on comprehensive observations of 20 wire icing events during winter from 2019 to 2021,we investigated the characteristics of the icing properties,the atmospheric boundary layer structure,the raindrop size distribution,and their associated effects on the ice accretion mechanism in the mountainous region of Southwest China.The maximum ice weight was positively correlated with the duration of ice accretion in the mountainous area.The duration of precipitation accounted for less than 20%of the icing period in the mountainous area,with solid-phase hydrometeors being predominant.Icing events,dominated by freezing rain(FR)and mixed rain–graupel(more than 70%),were characterized by glaze or highdensity mixed icing.The relationship between the melting energy and refreezing energy reflected the distribution characteristics of the proportion of FR under mixed-phase precipitation.The intensity of the warm layer and the dominant precipitation phase significantly affected the variations in the microphysical properties of FR.The melting of large dry snowflakes significantly contributed to FR in the mountainous areas,resulting in smaller generalized intercepts and larger mass-weighted mean diameters in the presence of a stronger warm layer.Under a weaker warm layer,the value of the massweighted mean diameter was significantly smaller because of the inability of large solid particles to melt.Finally,FR in the mountainous area dominated the ice weight during the rapid ice accumulation period.A numerical simulation of FR icing on wires effectively revealed the evolution of disaster-causing icing in mountainous areas.
基金National Natural Science Foundation of china(Grant No.12402468)。
文摘RBOE is a new type of DNAN-based high-energy melt-cast mixed explosive,whose safety under thermal stimulation is significantly affected by heating conditions and venting area of the warhead.Based on the thermal decomposition reaction characteristics and combustion characteristics of each component of RBOE explosive,the cook-off calculation models of RBOE warhead before and after ignition were established.In addition,closed and vented warheads were designed,as well as fast and slow cook-off test devices.The cook-off characteristics and thermal safety venting area of RBOE warhead were extensively studied.The results showed that the closed RBOE warhead underwent deflagration reaction under both slow and fast cook-off conditions.The calculation result of the shell wall temperature before slow cookoff ignition response of the warhead was 454.06 K,with an error of+1.75%compared to the test result of462.15 K,and the temperature rise rate calculated was in good agreement with the test.The calculated ignition time of RBOE warhead under fast cook-off was 161 s,with an error of+8.8%compared to the test result of 148 s,which verified the accuracy of cook-off model of RBOE warhead before ignition.According to the cook-off calculation model of the warhead after ignition and cook-off test of the vented warhead,it was determined that the thermal safety venting area was 1124.61 mm^(2)for fast cook-off and 530.66 mm~2 for slow cook-off,effectively preventing the reaction of warhead above combustion.Therefore,this study provides a scientific basis for the thermal safety design and evaluation of insensitive warheads.
基金supported by the Innovation Fund of Nanjing Institute of Environmental Science,Ministry of Ecology and Environment,China(No.ZX2023QT003)the National Natural Science Foundation of China(No.22306130)+1 种基金Jiangsu Funding Program for Excellent Postdoctoral Talent(No.2022ZB789)the Ecological Environment Research Project of Jiangsu Province,China(No.2022014).
文摘Phthalic acid esters(PAEs)are a group of compounds widespread in the environment.To investigate the occurrence and accumulation characteristics of PAEs,surface water samples were collected from the Three Gorges Reservoir area,China.The total concentrations of∑_(11)analyzed PAEs(11PAEs)in the collected water samples ranging from 197.7 to 1,409.3 ng/L(mean±IQR:583.1±308.4 ng/L).While DEHP was the most frequently detected PAE,DnBP and DnNP were the most predominant PAEs in the analyzed water samples with a mean contribution of 63.3%of the∑_(11)PAEs.The concentrations of the∑_(11)PAEs in the water samples from the upper reaches of the Yangtze River were significantly higher than those from themiddle reaches.To better understand the transport and fate of the PAEs,seven detected PAEs were modeled by Quantitative Water Air Sediment Interaction(QWASI).The simulated and measured values were close for most PAEs,and differences are within one order of magnitude even for the worst one.For all simulated PAEs,water and particle inflow were main sources in the reservoir,whereas water outflow and degradation in water were important removal pathways.The contribution ratios of different sources/losses varied fromPAEs,depending on their properties.The calculated risk quotients of DnNP in the Three Gorges Reservoir area whether based onmonitoring or simulating results were all far exceeded the safety threshold value,implying the occurrence of this PAE compound may cause potential adverse effects for the aquatic ecology of the Three Gorges Reservoir area.
基金supported by the Natural Science Foundation of Henan Province(252300421290)the National Natural Science Foundation of China(41771438)+1 种基金the Program for Innovative Research Team(in Science and Technology)of Henan University(22IRTSTHN010)the Postgraduate Education Reform and Quality Improvement Project of Henan Province(HNYJS2020JD14).
文摘Soil moisture(SM)is a critical variable in terrestrial ecosystems,especially in arid and semi-arid areas where water sources are limited.Despite its importance,understanding the spatiotemporal variations and influencing factors of SM in these areas remains insufficient.This study investigated the spatiotemporal variations and influencing factors of SM in arid and semi-arid areas of China by utilizing the extended triple collation(ETC),Mann-Kendall test,Theil-Sen estimator,ridge regression analysis,and other relevant methods.The following findings were obtained:(1)at the pixel scale,the long-term monthly SM data from the European Space Agency Climate Change Initiative(ESA CCI)exhibited the highest correlation coefficient of 0.794 and the lowest root mean square error(RMSE)of 0.014 m^(3)/m^(3);(2)from 2000 to 2022,the study area experienced significant increase in annual average SM,with a rate of 0.408×10^(-3)m^(3)/(m^(3)•a).Moreover,higher altitudes showed a notable upward trend,with SM increasing rates at 0.210×10^(-3)m^(3)/(m^(3)•a)between 1000 and 2000 m,0.530×10^(-3)m^(3)/(m^(3)•a)between 2000 and 4000 m,and 0.760×10^(-3)m^(3)/(m^(3)•a)at altitudes above 4000 m;(3)land surface temperature(LST),root zone soil moisture(RSM)(10-40 cm depth),and normalized difference vegetation index(NDVI)were identified as the primary factors influencing annual average SM,which accounted for 34.37%,24.16%,and 22.64%relative contributions,respectively;and(4)absolute contribution of LST was more significant in subareas at higher altitudes,with average absolute contributions of 0.800×10^(-3)m^(3)/(m^(3)•a)between 2000 and 4000 m and 0.500×10^(-2) m^(3)/(m^(3)•a)above 4000 m.This study reveals the spatiotemporal variations and main influencing factors of SM in Chinese arid and semi-arid areas,highlighting the more pronounced absolute contribution of LST to SM in high-altitude areas,providing valuable insights for ecological research and water resource management in these areas.
文摘Objective: Stroke is perceived as a serious illness although it is preventable, and lifestyle alterations can be made to reduce its risk. Improvement of stroke care should be achieved through awareness of public, especially through high-risk group. Henceforth, the aim of this study was to evaluate the effect of nursing intervention on improving awareness of high-risk people about stroke prevention. Methods: A quasi-experimental design was used to carry out this study, where a purposive sample of 80 adult patients at high risk for stroke were enrolled while they were attending the out-patient clinics of Zagazig University Hospitals for follow-up treatment;they were divided into two groups: case (40 patients) and control (40 patients). An interview questionnaire was used to assess patients’ knowledge regarding warning signs, risk factors, and immediate treatment;attitude;and their practice for prevention for stroke at pretest and posttest. Results: The study revealed the poor level of knowledge, bad level of preventive behavior, and negative attitude regarding stroke prevention at pre-intervention. However, after intervention, the high-risk people had fair level of knowledge with moderate practice for stroke prevention and positive attitude, with statistically significant difference between pre-post intervention and between the case and control groups. Conclusions: The study revealed that the nursing intervention seemed to change the knowledge, practice, and attitude of subjects regarding stroke prevention. This, in turn, implies that awareness of prevention of stroke and high-risk factor control could be important to reduce the burden of stroke in Egypt. Thus, further research on a larger scale is required to improve population knowledge and behavior for stroke prevention and control.
文摘Objective:To explore the perspectives of high-risk pregnant women regarding the home care program for high-risk pregnancies.Methods:This qualitative study was conducted in a university hospital and 5 comprehensive health centers in Ahvaz,Iran,from February 2023 to July 2023.The sampling method used was purposive sampling considering the maximum possible diversity,which continued until data saturation.11 in-depth and semistructured interviews were conducted with high-risk pregnant women.Data were simultaneously analysed using Graneheim and Lundman content analysis by MAXQDA version 20 software.Results:Data analysis extracted 3 themes,12 categories,and 26 subcategories.The themes and categories were“high-risk pregnancy and related issues(pursuing treatment and paying attention to the high-risk situation by pregnant women,psychological aspect of high-risk pregnancy on pregnant women and caregivers,emotional and physical aspects of high-risk pregnancy,the consequences of high-risk pregnancy on the people around them and empowerment of high-risk pregnant women)”,“support dimension(family and community support for high-risk pregnant women)”,and“framework of program(acculturalization,means and equipment,security,manpower and the necessary arrangements for the home care)”.Conclusions:High-risk pregnancy affects various aspects of the lives of high-risk pregnant women and their families.Creating the necessary conditions for providing care at home plays a vital role in supporting high-risk pregnant women and removing related obstacles to receiving prenatal care in person.It will be especially beneficial for high-risk pregnant women in low-income areas.
文摘In Niger, irrigated agriculture constitutes the main alternative for meeting family needs. It is within this framework that the state and its partners have adopted strategies to promote irrigated production sites. This study was carried out on the Konni irrigated perimeter, the objective of which is to analyze the physical state of hydraulic infrastructures and their operation before the rehabilitation of the said perimeter. The methodology adopted consisted, first of all, of documentary research focused on data relating to this scope and our theme to properly guide the collection of data in the field. The field phase was then followed with an observation of hydraulic infrastructures one by one in order to assess their condition. Thus, the collected data was processed and analyzed. The results of this study show a notable deterioration of hydraulic infrastructure which affected the operating yield of the study area, with the development of barely 700 ha out of 1226 ha planned by the basic study for off-season production (57%). Bathymetric measurements showed that the volume of sediment that accumulated in the Zongo Dam is 1.2 million m3, which reduces its initial capacity from 12 million m3 to 10.8 million m3 after 43 years of service. The expansion joints of the feed canal are all in poor condition. 90% of the total length of the tertiary canals are degraded, 82.32% of the panels of the main canal C are degraded and 17.68% are cracked. All crossing structures are blocked between the RN1 and the Zongo dam. Based on this critical situation, it would be essential to consider rehabilitation work on all infrastructure in order to restore the hydraulic and even agronomic performance of the Konni irrigated area.
基金supported by the Horizon Europe Framework Programme(HORIZON),call Teaming for Excellence(HORIZONWIDERA-2022-ACCESS-01-two-stage)-Creation of the Centre of Excellence in Smart Forestry“Forest 4.0”No.101059985″This research was cofunded by FOREST 4.0-“Ekscelencijos centras tvariai miško bioekonomikai vystyti”(Nr.10-042-P-0002).
文摘Models that predict a forest stand’s evolution are essential for developing plans for sustainable management.A simple mathematical framework was developed that con-siders the individual tree and stand basal area under random resource competition and is based on two assumptions:(1)a sigmoid-type stochastic process governs tree and stand basal area dynamics of living and dying trees,and(2)the total area that a tree may potentially occupy determines the number of trees per hectare.The most effective method to satisfy these requirements is formalizing each tree diameter and potentially occupied area using Gompertz-type stochastic differential equations governed by fixed and mixed-effect parameters.Data from permanent experimental plots from long-term Lithuania experiments were used to construct the tree and stand basal area models.The new models were relatively unbiased for live trees of all species,including silver birch(Betula pen-dula Roth)and downy birch(Betula pubescens Ehrh.),[spruce(Picea abies),and pine(Pinus sylvestris)].Less reliable predic-tions were made for the basal area of dying trees.Pines gave the highest accuracy prediction of mean basal area among all live trees.The mean basal area prediction for all dying trees was lower than that for live trees.Among all species,pine also had the best average basal area prediction accuracy for live trees.Newly developed basal area growth and yield models can be recommended despite their complex formulation and implementation challenges,particularly in situations when data is scarce.This is because the newly observed plot provides sufficient information to calibrate random effects.
文摘Background:Loneliness is a common experience for pregnant women and correlates with perinatal depression and negative pregnancy outcomes.Women experiencing a high-risk pregnancy are at greater risk for loneliness because of uncertainty with disease and the medicalization of pregnancy.International studies have identified an association between perceived stress and loneliness in pregnant women.The aim of this study is to explore factors related to loneliness among women of high-risk pregnancy,and to examine the associated relationship of loneliness and perceived stress.Methods:Using convenience sampling,109 women with high-risk pregnancies were enrolled.Data collection involved questionnaires on general demographic characteristics,the 6-item Loneliness Scale(ULS-6),and the Chinese version of the Perceived Stress Scale(CPSS-14).Data analysis was performed using SPSS 28.0 statistical software.Results:The mean loneliness score was 9.95±2.99,and the mean perceived stress score was 22.84±5.80.Women with high-risk pregnancies exhibited statistically significant differences in loneliness scores compared to the control group across among age,marital status,educational attainment,per capita monthly household income,spousal relationship,in-law relationship,and parental relationship(P<0.05).Correlation analysis revealed a positive correlation between loneliness and perceived stress(r=0.456,P<0.01).Multivariate regression analysis indicated that per capita monthly household income,marital relationship,in-law relationship,and perceived stress were the primary factors influencing loneliness among women with high-risk pregnancies(P<0.05).Conclusion:The results highlight the need for specific interventions addressing loneliness among women with high-risk pregnancies.Such interventions should focus on improving spousal and in-law relationships,reducing perceived stress,and implementing support measures,such as financial counseling or assistance programs,for those with lower per capita household income.This study establishes a foundation for the creation of integrated support systems that bring together families and healthcare providers to strengthen maternal mental health.
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.82200215,82170193,and 82370197)the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(Grant No.2022-I2M-1-002)。
文摘Objective:Our previous studies have indicated potentially higher proliferative activity of tumor cells in Chinese patients with mantle-cell lymphoma(MCL)than those in Western.Given the success and tolerability of R-DA-EDOCH immunochemotherapy in treating aggressive B-cell lymphomas,we designed a prospective,phase 3 trial to explore the efficacy and safety of alternating R-DA-EDOCH/R-DHAP induction therapy for young patients with newly diagnosed MCL.The primary endpoint was the complete remission rate(CRR)at the end of induction(EOI).Methods:A total of 55 patients were enrolled.The CRR at the EOI was 89.1%[95%confidence interval(CI)78%±96%],and the overall response rate was 98.1%(95%CI 90%±100%).Most patients with bone marrow involvement quickly attained minimal residual disease(MRD)negative status,with a 95.7%rate at the EOI.Results:The 3-year progression-free survival(PFS)and overall survival rates were 66.3%and 83.2%,respectively.No patients discontinued treatment because of adverse events.Univariate analysis identified pathologic morphology and TP53 mutations as risk factors for PFS.However,high tumor proliferative activity and certain cytogenetic abnormalities showed no significant adverse prognostic significance.Conclusions:Intensive therapy based on a high cytarabine dose and continuously administered EDOCH achieved a high MRDnegative rate and provides an optional induction choice for young patients with MCL with high-risk factors.
文摘Pregnant women with high-risk pregnancy face a higher risk of complications due to factors such as chronic diseases,multiple pregnancies,and a history of adverse pregnancy and childbirth,requiring more systematic and dynamic health management support.In view of this,“Internet+continuous nursing”can break the limitations of time and space by integrating mobile communication,remote monitoring,data sharing,and intelligent analysis technologies,realizing closed-loop care with collaboration among hospitals,communities,and families.Research shows that continuous nursing based on the“Internet+”significantly improves the professional response ability of caregivers.Medical staff can grasp the patient’s status in real time,optimize diagnosis and treatment decisions,providing a feasible path for building an efficient,precise,and humanized high-risk pregnancy management system,which has broad clinical promotion value and public health significance.
基金funded by grants EVA4.0 No.Z.02.1.01/0.0/0.0/16_019/0000803 and ITMS2014+313011W580s provided by EU OP RDEin CZ and SKprojects APVV-18-0086,APVV-19-0387,APVV-20-0168,APVV-20-0215 and APVV-22-0056 from the Slovak Research and Development Agencysupport from the European Research Executive Agency for ReForest,Grant Agreement Nr:101060635
文摘While numerous allometric models exist for estimating biomass in trees with single stems,models for multi-stemmed species are scarce.This study presents models for predicting aboveground biomass(AGB)in European hazel(Corylus avellana L.),growing in multi-stemmed shrub form.We measured the size and harvested the biomass of 30 European hazel shrubs,drying and weighing their woody parts and leaves separately.AGB(dry mass)and leaf area models were established using a range of predictors,such as the upper height of the shrub,number of shoots per shrub,canopy projection area,stem base diameter of the thickest stem,and the sum of cross-sectional areas of all stems at the stem base.The latter was the best predictor of AGB,but the most practically useful variables,defined as relatively easy to measure by terrestrial or aerial approaches,were the upper height of the shrub and the canopy projection area.The leaf biomass to AGB ratio decreased with the shrub's height.Specific leaf area of shaded leaves increases with shrub height,but that of leaves at the top of the canopy does not change significantly.Given that the upper shrub height and crown projection of European hazel can be estimated using remote sensing approaches,especially UAV and LIDAR,these two variables appear the most promising for effective measurement of AGB in hazel.
