BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery...BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery speed and quality of life.Effective prevention of anxiety and depression in elderly patients has become an urgent problem.AIM To investigate the trajectory of anxiety and depression levels in elderly patients after LIF,and the influencing factors.METHODS Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital.General information and surgery-related indices were recorded,and participants completed measures of psychological status,lumbar spine dysfunction,and quality of life.A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels,and unordered multi-categorical logistic regression was used to analyze the influencing factors.RESULTS Three trajectories of change in anxiety level were identified:Increasing anxiety(n=26,10.88%),decreasing anxiety(n=27,11.30%),and stable anxiety(n=186,77.82%).Likewise,three trajectories of change in depression level were identified:Increasing depression(n=30,12.55%),decreasing depression(n=26,10.88%),and stable depression(n=183,76.57%).Regression analysis showed that having no partner,female sex,elevated Oswestry dysfunction index(ODI)scores,and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels,whereas female sex,postoperative opioid use,and elevated ODI scores all contributed to increased depression levels.CONCLUSION During clinical observation,combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention,quickens recovery,and enhances quality of life.展开更多
Major chemical ionic components in water serve as indicators of natural factors in the areas traversed by water bodies,and are thus widely used to elucidate key hydrogeochemical processes,including rock weathering,aqu...Major chemical ionic components in water serve as indicators of natural factors in the areas traversed by water bodies,and are thus widely used to elucidate key hydrogeochemical processes,including rock weathering,aquatic evaporation-crystallization,and the input of precipitation-derived materials into river basins.A total of 208 water samples were collected between August 2021 and August 2022 to investigate the hydrochemical characteristics and their influencing factors of the surface water and the groundwater in the Mingyong River Basin.To systematically analyze the data,we combined hydrogeochemical and statistical methods:descriptive statistics characterized ion concentration and physicochemical parameter distributions;Piper trilinear diagrams classified hydrochemical types;Pearson correlation analysis assessed ion-ion and ionTDS dependencies;Gibbs diagrams and ion ratio analysis identified solute sources;and the absolute principal component score-multiple linear regression(APCS-MLR)model quantified the contribution rates of different influencing factors.The results revealed that the dominant cations in the surface water and groundwater are Ca^(2+)and Mg^(2+),while the dominant anions are HCO_(3)^(-)and SO_(4)^(2-).The groundwater exhibits an extended residence time within rock strata,facilitating prolonged interaction with soluble minerals and intensifying the water-rock reaction process,thereby resulting in higher levels of electrical conductivity(EC),pH,and total dissolved solids(TDS)than those in the surface water.Secondly,the parameters of the surface water and groundwater indicate positive correlation.The weathering of rocks constitutes the primary solute source in the water of the basin.The hydrochemical composition of the basin water is primarily influenced by both carbonate and silicate rocks,with a minor contribution from evaporite rocks.The water bodies in the basin are affected by anthropogenic activities.The surface water is influenced by four sources,namely lixiviation-enrich,human activities,geological environmental,and unknown sources.The groundwater is influenced by five sources,namely lixiviation-enrich,primary geological,human activities,geological environmental,and unknown sources.展开更多
Tuberculosis(TB),one of the oldest infectious diseases caused by Mycobacterium tuberculosis,poses a considerable challenge to global public health.There are approximately 10 million new TB cases worldwide annually,and...Tuberculosis(TB),one of the oldest infectious diseases caused by Mycobacterium tuberculosis,poses a considerable challenge to global public health.There are approximately 10 million new TB cases worldwide annually,and TB claims the lives of nearly 3 million people each year,making it one of the leading causes of death from a single infectious disease[1].China ranks third globally in terms of TB burden,with approximately 733,000 TB cases reported in 2023[2].Based on the ecological model of health determinants developed by Whitehead and Dahlgren,health determinants can be classified into direct causes.展开更多
This paper provides a systematic review of the histochemical localization,content characteristics,and influencing factors of saponins in Pseudostellaria heterophylla based on an extensive literature survey.It provides...This paper provides a systematic review of the histochemical localization,content characteristics,and influencing factors of saponins in Pseudostellaria heterophylla based on an extensive literature survey.It provides an in-depth analysis and summary of the effects of biological factors,environmental conditions,agronomic practices,processing methods,and continuous cropping obstacles on the synthesis of P.heterophylla saponins,as well as their underlying mechanisms.Based on identified gaps in the current literature,future research directions and prospects are proposed.The findings of this review offer valuable insights for advancing the understanding of the saponin biosynthesis mechanisms in P.heterophylla and for enhancing its quality.展开更多
The discharge of micro-polluted water from sources such as agricultural runoff,urban stormwater,and treated effluents presents significant challenges to aquatic ecosystems.Constructed wetlands(CWs)have gained recog-ni...The discharge of micro-polluted water from sources such as agricultural runoff,urban stormwater,and treated effluents presents significant challenges to aquatic ecosystems.Constructed wetlands(CWs)have gained recog-nition as an eco-friendly solution for removing pollutants from various wastewater sources and are increasingly applied for micro-polluted water treatment.By reviewing 78 full-scale CW studies from Web of Science,it is summarized that the ranges of ammonium nitrogen(NH4+-N)concentrations in runoff,wastewater treatment plant effluent and polluted river were 0.1–6.6,0.3–12.3,and 0.2–41.1 mg/L,respectively.The ranges of ni-trate nitrogen concentrations were 0.2–14.2,0–5.7,and 0–2.6 mg/L,respectively.Removal efficiencies of CWs for micro-polluted water varied by CW types.The total nitrogen removal efficiencies for subsurface-flow CWs,free-water surface-flow CWs,and hybrid CWs ranged from 27.4%to 66.5%,16.8%to 89.8%,and 19.4%to 88.2%,respectively.The NH4+-N removal efficiencies ranged from 34.2%to 73.6%,38.4%to 89.4%and 13.5%to 94.2%,respectively.Additionally,other factors influencing contaminant removal efficiency such as hydraulic retention time,vegetation types,redox micro-environment and influent water quality were evaluated.Based on these findings,two strategies for improving the purification performance of CWs were proposed:the selection of incorporating electron donor substrates and the optimization of operation parameters.This paper serves as a synthesis of information to guide future research and full-scale CW applications in micro-polluted water treatment.展开更多
Background:The trajectory of intrinsic capacity(IC)among the older population is characterized by its diversity and is predictive of adverse health outcomes such as disability,nursing home admission,decline in quality...Background:The trajectory of intrinsic capacity(IC)among the older population is characterized by its diversity and is predictive of adverse health outcomes such as disability,nursing home admission,decline in quality of life,and mortality.Gaining an understanding of the trajectory of IC and the factors that influence it is of paramount importance for fostering healthy aging.This research is focused on exploring the trajectory of IC among older adults in China and examining the factors that influence it.Methods:This observational longitudinal cohort study leveraged data from the China Health and Retirement Longitudinal Study(CHARLS),which was conducted in the years 2011,2013,and 2015.For the purpose of this analysis,a total of 2,233 participants who were aged 60 and over were included.A Growth Mixture Model(GMM)was utilized to define trajectory categories for IC.Influential factors were ascertained based on the health ecology model,and binary logistic regression analysis was utilized to investigate the factors linked with the different trajectory categories.Results:Two distinct trajectory classes of IC were identified:Class 1,the normal-stable group,encompassed 90.4%of the elderly population,while Class 2,the declining group,made up 9.6%.Advanced age and a history of stroke were found to be significantly associated with Class 2.High scores in activities of daily living(ADL),employment status,receiving primary or junior high school education,and residence in the East or Central regions of China were significantly linked with Class 1.Conclusion:The trajectory of IC among older Chinese adults is marked by its heterogeneity.Advanced age and a history of stroke are significant risk factors for a declining IC trajectory,while higher ADL scores,being employed,receiving primary or junior high school education,and residing in the East or Central regions of China are protective factors associated with a stable IC trajectory.Healthcare institutions must closely monitor IC levels and understand these trajectory patterns to implement personalized and targeted interventions promptly to maintain IC at a healthy level and advocate for healthy aging.展开更多
Water use efficiency(WUE),as a pivotal indicator of the coupling degree within the carbon–water cycle of ecosystems,holds considerable importance in assessment of the carbon–water balance within terrestrial ecosyste...Water use efficiency(WUE),as a pivotal indicator of the coupling degree within the carbon–water cycle of ecosystems,holds considerable importance in assessment of the carbon–water balance within terrestrial ecosystems.However,in the context of global warming,WUE evolution and its primary drivers on the Tibetan Plateau remain unclear.This study employed the ensemble empirical mode decomposition method and the random forest algorithm to decipher the nonlinear trends and drivers of WUE on the Tibetan Plateau in 2001–2020.Results indicated an annual mean WUE of 0.8088 gC/mm·m^(2)across the plateau,with a spatial gradient reflecting decrease from the southeast toward the northwest.Areas manifesting monotonous trends of increase or decrease in WUE accounted for 23.64%and 9.69%of the total,respectively.Remarkably,66.67%of the region exhibited trend reversals,i.e.,39.94%of the area of the Tibetan Plateau showed transition from a trend of increase to a trend of decrease,and 26.73%of the area demonstrated a shift from a trend of decrease to a trend of increase.Environmental factors accounted for 70.79%of the variability in WUE.The leaf area index and temperature served as the major driving forces of WUE variation.展开更多
BACKGROUND The development of hepatocellular carcinoma(HCC)is influenced by multiple factors.Interventional therapy offers an effective treatment option for patients with unresectable intermediate-to-advanced HCC.Inte...BACKGROUND The development of hepatocellular carcinoma(HCC)is influenced by multiple factors.Interventional therapy offers an effective treatment option for patients with unresectable intermediate-to-advanced HCC.Interventional therapy can induce electrocardiographic(ECG)abnormalities that may be associated with liver dysfunction,electrolyte disorders,and cardiac injury.AIM To explore the ECG alterations and determinants following interventional therapy in patients with HCC.METHODS Sixty patients undergoing interventional treatment for liver cancer were selected as study participants.According to the results of the dynamic ECG examination 1 day after surgery,the patients were divided into an abnormal group(n=21)and a nonabnormal group(n=39).With the help of dynamic ECG examination,the ECG parameters were compared and the baseline data of patients was recorded in the two groups.RESULTS The 24 hours QT interval variability,24 hours normal atrial polarization to ventricular polarization(R-R)interval(standard deviation),24 hours consecutive 5 minutes normal R-R interval,and 24 hours continuous 5 minutes normal R-R interval(standard deviation mean)were lower than patients in the nonabnormal group(P<0.05).The logistic analysis showed that age>60 years,liver function grade B,and postoperative body temperature 38°C were risk factors for abnormal dynamic electrocardiogram in patients with liver cancer intervention(P<0.05).CONCLUSION Interventional therapy for HCC can lead to ECG abnormalities,underscoring the clinical need for enhanced cardiac monitoring to mitigate myocardial complications.展开更多
BACKGROUND China has recently encountered severe challenges associated with population aging.Parents of first-generation only children face significant challenges regarding elderly care needs and the associated negati...BACKGROUND China has recently encountered severe challenges associated with population aging.Parents of first-generation only children face significant challenges regarding elderly care needs and the associated negative emotions.AIM To analyze the elderly care needs of first-generation only child parents in China and identify factors that influence negative emotions.METHODS This study used a cross-sectional design.Convenience sampling was used to select 1580 elderly individuals who met the inclusion criteria in a Chinese city between June and September 2022.A questionnaire was administered to collect general information about participants.Depression and anxiety were assessed using the patient health questionnaire-9 and generalized anxiety disorder-7 scale,respectively.A logistic regression analysis was performed to evaluate the relevant correlations.RESULTS Among 1580 first-generation only child parents,1120(70.89%)preferred family based care,324(20.51%)opted for community care,and 136(8.61%)chose institutional care,with 460(29.11%)reporting negative emotions.Significant differences in the distribution of negative emotions among only child parents were observed based on age,marital status,living conditions,disability,type of chronic disease,frailty status,and family support(P<0.05).The regression analysis indicated that disability,type of chronic disease,living environment,frailty status,and level of family support were independent risk factors for negative emotions among parents with only children(P<0.05).CONCLUSION Elderly care for parents of only children is primarily family-based.Independent risk factors for negative emotions in this group include disability,chronic disease type,and living environment.展开更多
Thyroid cancer is a common endocrine malignancy with a rising incidence.Pa-tients often suffer from mental pain due to concerns about recurrence,treatment-related side-effect,and body image changes.Demographic factors...Thyroid cancer is a common endocrine malignancy with a rising incidence.Pa-tients often suffer from mental pain due to concerns about recurrence,treatment-related side-effect,and body image changes.Demographic factors like age,gender,physiological factors such as somatic symptoms and disease stage,co-gnitive-regulatory factors including negative and positive thinking,and social factors like work,economy,education level,and social support all influence their mental state.Existing interventions,including nursing,psychological,and tra-ditional Chinese medicine-based methods,have some benefits but face limitations like short-term effectiveness and lack of standardization.Future research should focus on creating better-defined,long-term,and widely applicable intervention programs and explore positive psychology-based approaches to improve patients'mental well-being and quality of life.展开更多
BACKGROUND Patients with middle and advanced hepatocellular carcinoma(HCC)frequently experience significant anxiety and depression,severely affecting their quality of life.AIM To examine the anxiety and depression sta...BACKGROUND Patients with middle and advanced hepatocellular carcinoma(HCC)frequently experience significant anxiety and depression,severely affecting their quality of life.AIM To examine the anxiety and depression status of patients with middle and advanced HCC,the influencing factors,and the correlation between these psychological factors and quality of life.METHODS We collected baseline data from 100 patients with HCC,assessing anxiety and depression levels using the Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD).Quality of life was evaluated with the Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire.Multivariate logistic regression analyzed clinical and psychosocial factors affecting anxiety and depression,while Pearson correlation assessed relationships among HAMA,HAMD,and Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire scores.RESULTS Results indicated that 64%of patients exhibited anxiety and 65%showed depression symptoms.Key influencing factors included Barcelona Clinic Liver Cancer C stage,multiple tumors,social support,prior treatments(such as liver resection and transcatheter arterial chemoembolization/hepatic artery infusion chemotherapy),as well as HAMA and HAMD scores.Anxiety and depression correlated negatively with quality of life,with coefficients of-0.671 and-0.575 for HAMA and HAMD,respectively.CONCLUSION Anxiety and depression are prevalent among patients with middle and advanced HCC,impacting quality of life.This underscores the need for psychological health considerations in liver cancer treatment and establishing psychological interventions is essential.展开更多
Objective Accurately identifying the key influencing factors of psychological birth trauma in primiparous women is crucial for implementing effective preventive and intervention measures.This study aimed to develop an...Objective Accurately identifying the key influencing factors of psychological birth trauma in primiparous women is crucial for implementing effective preventive and intervention measures.This study aimed to develop and validate an interpretable machine learning prediction model for identifying the key influencing factors of psychological birth trauma in primiparous women.Methods A multicenter cross-sectional study was conducted on primiparous women in four tertiary hospitals in Sichuan Province,southwestern China,from December 2023 to March 2024.The Childbirth Trauma Index was used in assessing psychological birth trauma in primiparous women.Data were collected and randomly divided into a training set(80%,n=289)and a testing set(20%,n=73).Six different machine learning models were trained and tested.Training and prediction were conducted using six machine learning models included Linear Regression,Support Vector Regression,Multilayer Perceptron Regression,eXtreme Gradient Boosting Regression,Random Forest Regression,and Adaptive Boosting Regression.The optimal model was selected based on various performance metrics,and its predictive results were interpreted using SHapley Additive exPlanations(SHAP)and accumulated local effects(ALE).Results Among the six machine learning models,the Multilayer Perceptron Regression model exhibited the best overall performance in the testing set(MAE=3.977,MSE=24.832,R2=0.507,EVS=0.524,RMSE=4.983).In the testing set,the R2 and EVS of the Multilayer Perceptron Regression model increased by 8.3%and 1.2%,respectively,compared to the traditional linear regression model.Meanwhile,the MAE,MSE,and RMSE decreased by 0.4%,7.3%,and 3.7%,respectively,compared to the traditional linear regression model.The SHAP analysis indicated that intrapartum pain,anxiety,postpartum pain,resilience,and planned pregnancy are the most critical influencing factors of psychological birth trauma in primiparous women.The ALE analysis indicated that higher intrapartum pain,anxiety,and postpartum pain scores are risk factors,while higher resilience scores are protective factors.Conclusions Interpretable machine learning prediction models can identify the key influencing factors of psychological birth trauma in primiparous women.SHAP and ALE analyses based on the Multilayer Perceptron Regression model can help healthcare providers understand the complex decision-making logic within a prediction model.This study provides a scientific basis for the early prevention and personalized intervention of psychological birth trauma in primiparous women.展开更多
This paper thoroughly explores the multifaceted factors influencing the efficacy of Chinese medicinals and categorizes them into three main groups:medicinal related factors,patient related factors,and practitioner rel...This paper thoroughly explores the multifaceted factors influencing the efficacy of Chinese medicinals and categorizes them into three main groups:medicinal related factors,patient related factors,and practitioner related factors.Regarding medicinal related factors,the place of origin,growing environment,harvesting time,storage conditions,quality control,dosage form selection,compatibility of medicinals,precise dosing,decoction methods,and administration routes all significantly impact efficacy.The place of origin determines the authenticity of medicinals,the growing environment affects their composition,harvesting time influences potency,improper storage leads to deterioration,quality control forms the foundation of efficacy,dosage forms and compatibility of medicinals affect absorption,dosing and decoction methods require precision,and administration routes should be tailored to individuals.Patient related factors include psychological state,individual differences,background,and disease condition.Psychological state affects treatment compliance,individual differences determine medicine responses,background influences patients’understanding of Chinese medicinals,and disease condition directly reflects efficacy.Practitioner related factors encompass theoretical knowledge,clinical experience,inherited practices,psychological state,and professional ethics.Theoretical knowledge guides medication use,clinical experience enhances efficacy,inherited practices influence prescribing styles,psychological state affects doctor–patient communication,and professional ethics ensure medical quality.These interrelated factors collectively influence the efficacy of Chinese medicinals,emphasizing the need for comprehensive consideration in clinical applications to achieve optimal therapeutic outcomes.展开更多
Cross-border e-commerce,as a new form of international trade,has shown great development potential in the context of the“Belt and Road”initiative.Based on the cross-border e-commerce export data from 2015 to 2024,th...Cross-border e-commerce,as a new form of international trade,has shown great development potential in the context of the“Belt and Road”initiative.Based on the cross-border e-commerce export data from 2015 to 2024,this paper analyzes the influencing factors of China's cross-border e-commerce exports to countries along the“Belt and Road”by constructing an econometric model.The study found that factors such as the perfection of digital infrastructure,the efficiency of logistics and transportation,the convenience of payment and settlement,and the penetration rate of consumers online shopping significantly affect the export scale of cross-border e-commerce.Institutional factors such as the development level of e-commerce platforms in countries along the route,market access thresholds,and tariff policies also play an important role.Based on the research results,suggestions are put forward to strengthen the construction of cross-border payment system,optimize the logistics distribution network,promote customs clearance facilitation,and deepen cooperation in the field of e-commerce,to provide references for promoting the development of China's crossborder e-commerce exports to countries along the“Belt and Road.”展开更多
[Objectives]To study the factors influencing the tourism economy in Henan Province.[Methods]Using tourism-related data from Henan Province covering the period from 2000 to 2020,this study constructs a regression model...[Objectives]To study the factors influencing the tourism economy in Henan Province.[Methods]Using tourism-related data from Henan Province covering the period from 2000 to 2020,this study constructs a regression model based on multivariate statistical methods to investigate the determinants of the tourism economy.The dependent variable in the model is the domestic tourism revenue of Henan Province,while the independent variables comprise the number of tourist arrivals,total operational railway mileage,the number of travel agencies,and the per capita disposable income of urban residents.[Results]Both the total railway mileage and the per capita disposable income of urban residents are the primary factors influencing the development of Henan's tourism economy.[Conclusions]It is recommended to reduce uncertainty and liquidity constraints to mitigate residents'precautionary savings behavior,actively expand domestic demand to leverage tourism as an economic driver,and improve infrastructure to support tourism development.展开更多
Based on questionnaire data from Niutouzhen Village Units 1-7 in Shuangwangcheng Economic Zone,Shouguang City,Shandong Province,this study employs a binary logistic regression model to explore the factors influencing ...Based on questionnaire data from Niutouzhen Village Units 1-7 in Shuangwangcheng Economic Zone,Shouguang City,Shandong Province,this study employs a binary logistic regression model to explore the factors influencing farmers'willingness to transfer farmland,and uses SPSS 27.0 software to perform regression analysis on the data.The results indicate that farmers'educational level,age of the household head,and contracted land area have a positive influence on farmers'willingness to transfer farmland at the 0.05 significance level,while annual household income has a positive influence at the 0.10 significance level.Furthermore,based on the regression analysis results,measures are proposed,including establishing and improving the rural land transfer compensation mechanism,enhancing publicity for land transfer,refining land transfer laws and regulations,optimizing the rural social security system,and actively expanding non-agricultural employment channels.These measures are intended to provide references for promoting farmland transfer work in Shouguang City.展开更多
Objective:To explore the barriers and facilitators associated with the implementation of horticultural activities(HA)in nursing care homes,and aim to identify findings that will enhance the development of more effecti...Objective:To explore the barriers and facilitators associated with the implementation of horticultural activities(HA)in nursing care homes,and aim to identify findings that will enhance the development of more effective implementation strategies for such activities.Methods:This qualitative descriptive study recruited a purposive sample of potential adopters related to HA in nursing care homes,and the conventional content analysis method was adopted.Results:A total of 6 older adults,3 social workers,1 nurse,and 1 physician participated in this study.The analysis revealed 4 themes barriers and 2 themes facilitators to the implementation of HA.Conclusions:Future intervention programs should be meticulously designed to address the identified influencing factors,and the insights gained can serve as a reference for identifying and mitigating barriers in the implementation of other physical activity programs.In turn,this will contribute to improved physical functioning and healthy aging.展开更多
Adolescence is a crucial period marked by significant developmental changes,during which risk-taking behaviors can be both a normative part of development and a potential source of concern.However,prior research has f...Adolescence is a crucial period marked by significant developmental changes,during which risk-taking behaviors can be both a normative part of development and a potential source of concern.However,prior research has focused predominantly on the adverse aspects of risk-taking(i.e.,negative risk-taking),overlooked the positive counterpart(i.e.,positive risk-taking),and lacked a detailed examination of both.This study aims to elucidate the distinct characteristics and interrelationships of positive and negative risk-taking behaviors among adoles-cents and to identify the key factors that influence these behaviors.Through a comprehensive synthesis of theoretical and empirical literature,we explore the multifaceted nature of risk-taking,highlighting its complex influencing factors,including individual traits,family dynamics,peer influence,school environment,and broader community contexts.By identifying the shared and unique factors contributing to positive and negative risk-taking behaviors,we can enable adolescents to navigate this complex stage of life and design targeted interventions.Future research directions include the application of person-centered approaches,the implementation of longitudinal tracking and the interactive effects of influencing factors,among other aspects.展开更多
BACKGROUND Glaucoma,a condition frequently linked to severe depression,anxiety,and sleep disturbances,affects treatment adherence while potentially compromising effectiveness.AIM To explore illness uncertainty(IU),anx...BACKGROUND Glaucoma,a condition frequently linked to severe depression,anxiety,and sleep disturbances,affects treatment adherence while potentially compromising effectiveness.AIM To explore illness uncertainty(IU),anxiety,and depressive symptoms in primary glaucoma and to discuss underlying triggers.METHODS We recruited 120 primary glaucoma cases between January 2022 and November 2023.The Mishel Uncertainty in Illness Scale(MUIS)and the Hospital Anxiety and Depression Scale(HADS)[include HADS-anxiety subscale(HADS-A)and HADS-depression subscale(HADS-D)]subscales,were used to assess IU and emotional distress(anxiety/depression),respectively.The MUIS-HADS subscale interrelationships were determined by Pearson correlation.IU-associated determinants were identified using univariate and binary logistic regression analyses.RESULTS The cohort showed a mean MUIS score of 79.73±8.97,corresponding to a moderately high IU level.The HADS-A and HADS-D scores averaged 6.57±3.89 and 7.08±5.05 points,respectively,with 15.00%of participants showing anxiety symptoms and 24.17%exhibiting depressive signs.Significant positive connections were observed between MUIS and both HADS-A(r=0.359,P<0.001)and HADSD(r=0.426,P<0.001).Univariate analysis revealed that disease duration,insomnia,monthly household income per capita,and the presence of comorbid chronic conditions were significantly associated with anxiety or depression.Multivariate analysis identified insomnia as a risk factor and higher monthly household income as a protective factor.CONCLUSION Patients with primary glaucoma experience moderate IU levels,generally low anxiety,and mild depression.Specifically,the anxiety and depression risks were 15.00%and 24.17%,respectively.A significant positive correlation existed between IU and anxiety/depression in these patients.Additionally,insomnia or lower monthly household income elevated anxiety/depression risks,enabling reliable anxiety/depression risk categorization among patients.展开更多
基金Supported by the Scientific Research Projects of the Health System in Pingshan District,No.2023122.
文摘BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery speed and quality of life.Effective prevention of anxiety and depression in elderly patients has become an urgent problem.AIM To investigate the trajectory of anxiety and depression levels in elderly patients after LIF,and the influencing factors.METHODS Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital.General information and surgery-related indices were recorded,and participants completed measures of psychological status,lumbar spine dysfunction,and quality of life.A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels,and unordered multi-categorical logistic regression was used to analyze the influencing factors.RESULTS Three trajectories of change in anxiety level were identified:Increasing anxiety(n=26,10.88%),decreasing anxiety(n=27,11.30%),and stable anxiety(n=186,77.82%).Likewise,three trajectories of change in depression level were identified:Increasing depression(n=30,12.55%),decreasing depression(n=26,10.88%),and stable depression(n=183,76.57%).Regression analysis showed that having no partner,female sex,elevated Oswestry dysfunction index(ODI)scores,and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels,whereas female sex,postoperative opioid use,and elevated ODI scores all contributed to increased depression levels.CONCLUSION During clinical observation,combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention,quickens recovery,and enhances quality of life.
基金funded by the National Natural Science Foundation of China(No.42061012)the Open Project of Yunnan Province’s First Class Discipline of Soil and Water Conservation and Desertification Control(SBK20240019)。
文摘Major chemical ionic components in water serve as indicators of natural factors in the areas traversed by water bodies,and are thus widely used to elucidate key hydrogeochemical processes,including rock weathering,aquatic evaporation-crystallization,and the input of precipitation-derived materials into river basins.A total of 208 water samples were collected between August 2021 and August 2022 to investigate the hydrochemical characteristics and their influencing factors of the surface water and the groundwater in the Mingyong River Basin.To systematically analyze the data,we combined hydrogeochemical and statistical methods:descriptive statistics characterized ion concentration and physicochemical parameter distributions;Piper trilinear diagrams classified hydrochemical types;Pearson correlation analysis assessed ion-ion and ionTDS dependencies;Gibbs diagrams and ion ratio analysis identified solute sources;and the absolute principal component score-multiple linear regression(APCS-MLR)model quantified the contribution rates of different influencing factors.The results revealed that the dominant cations in the surface water and groundwater are Ca^(2+)and Mg^(2+),while the dominant anions are HCO_(3)^(-)and SO_(4)^(2-).The groundwater exhibits an extended residence time within rock strata,facilitating prolonged interaction with soluble minerals and intensifying the water-rock reaction process,thereby resulting in higher levels of electrical conductivity(EC),pH,and total dissolved solids(TDS)than those in the surface water.Secondly,the parameters of the surface water and groundwater indicate positive correlation.The weathering of rocks constitutes the primary solute source in the water of the basin.The hydrochemical composition of the basin water is primarily influenced by both carbonate and silicate rocks,with a minor contribution from evaporite rocks.The water bodies in the basin are affected by anthropogenic activities.The surface water is influenced by four sources,namely lixiviation-enrich,human activities,geological environmental,and unknown sources.The groundwater is influenced by five sources,namely lixiviation-enrich,primary geological,human activities,geological environmental,and unknown sources.
基金supported by the National Natural Science Foundation of China(82574173,82003516)Jiangsu Provincial Natural Science Foundation(BK20251958)+2 种基金Jiangsu Provincial Medical Key Discipline(ZDXK202250)Top Talent Awards Project Fund(RDF-TP-0023,RDF-TP-0030)Postgraduate Research Fund(PGRS2112022)at Xi'an Jiaotong-Liverpool University.
文摘Tuberculosis(TB),one of the oldest infectious diseases caused by Mycobacterium tuberculosis,poses a considerable challenge to global public health.There are approximately 10 million new TB cases worldwide annually,and TB claims the lives of nearly 3 million people each year,making it one of the leading causes of death from a single infectious disease[1].China ranks third globally in terms of TB burden,with approximately 733,000 TB cases reported in 2023[2].Based on the ecological model of health determinants developed by Whitehead and Dahlgren,health determinants can be classified into direct causes.
基金Supported by Open Fund Project of the Engineering Technology Research Center of Characteristic Medicinal Plants of Fujian(PP202003).
文摘This paper provides a systematic review of the histochemical localization,content characteristics,and influencing factors of saponins in Pseudostellaria heterophylla based on an extensive literature survey.It provides an in-depth analysis and summary of the effects of biological factors,environmental conditions,agronomic practices,processing methods,and continuous cropping obstacles on the synthesis of P.heterophylla saponins,as well as their underlying mechanisms.Based on identified gaps in the current literature,future research directions and prospects are proposed.The findings of this review offer valuable insights for advancing the understanding of the saponin biosynthesis mechanisms in P.heterophylla and for enhancing its quality.
基金supported by the Natural Science Foundation of China(No.52470105)the Young Taishan Scholars Program of Shandong Province(No.358202103017).
文摘The discharge of micro-polluted water from sources such as agricultural runoff,urban stormwater,and treated effluents presents significant challenges to aquatic ecosystems.Constructed wetlands(CWs)have gained recog-nition as an eco-friendly solution for removing pollutants from various wastewater sources and are increasingly applied for micro-polluted water treatment.By reviewing 78 full-scale CW studies from Web of Science,it is summarized that the ranges of ammonium nitrogen(NH4+-N)concentrations in runoff,wastewater treatment plant effluent and polluted river were 0.1–6.6,0.3–12.3,and 0.2–41.1 mg/L,respectively.The ranges of ni-trate nitrogen concentrations were 0.2–14.2,0–5.7,and 0–2.6 mg/L,respectively.Removal efficiencies of CWs for micro-polluted water varied by CW types.The total nitrogen removal efficiencies for subsurface-flow CWs,free-water surface-flow CWs,and hybrid CWs ranged from 27.4%to 66.5%,16.8%to 89.8%,and 19.4%to 88.2%,respectively.The NH4+-N removal efficiencies ranged from 34.2%to 73.6%,38.4%to 89.4%and 13.5%to 94.2%,respectively.Additionally,other factors influencing contaminant removal efficiency such as hydraulic retention time,vegetation types,redox micro-environment and influent water quality were evaluated.Based on these findings,two strategies for improving the purification performance of CWs were proposed:the selection of incorporating electron donor substrates and the optimization of operation parameters.This paper serves as a synthesis of information to guide future research and full-scale CW applications in micro-polluted water treatment.
基金China Health and Retirement Longitudinal Study(CHARLS)the 2022-2023 Nursing Research Project of Chinese Medical Association Publishing House(Grant No.CMAPH-NRD2022024)。
文摘Background:The trajectory of intrinsic capacity(IC)among the older population is characterized by its diversity and is predictive of adverse health outcomes such as disability,nursing home admission,decline in quality of life,and mortality.Gaining an understanding of the trajectory of IC and the factors that influence it is of paramount importance for fostering healthy aging.This research is focused on exploring the trajectory of IC among older adults in China and examining the factors that influence it.Methods:This observational longitudinal cohort study leveraged data from the China Health and Retirement Longitudinal Study(CHARLS),which was conducted in the years 2011,2013,and 2015.For the purpose of this analysis,a total of 2,233 participants who were aged 60 and over were included.A Growth Mixture Model(GMM)was utilized to define trajectory categories for IC.Influential factors were ascertained based on the health ecology model,and binary logistic regression analysis was utilized to investigate the factors linked with the different trajectory categories.Results:Two distinct trajectory classes of IC were identified:Class 1,the normal-stable group,encompassed 90.4%of the elderly population,while Class 2,the declining group,made up 9.6%.Advanced age and a history of stroke were found to be significantly associated with Class 2.High scores in activities of daily living(ADL),employment status,receiving primary or junior high school education,and residence in the East or Central regions of China were significantly linked with Class 1.Conclusion:The trajectory of IC among older Chinese adults is marked by its heterogeneity.Advanced age and a history of stroke are significant risk factors for a declining IC trajectory,while higher ADL scores,being employed,receiving primary or junior high school education,and residing in the East or Central regions of China are protective factors associated with a stable IC trajectory.Healthcare institutions must closely monitor IC levels and understand these trajectory patterns to implement personalized and targeted interventions promptly to maintain IC at a healthy level and advocate for healthy aging.
基金National Nonprofit Institute Research Grant of CAF,No.CAFYBB2018ZA004,No.CAFYBB2023ZA009Fengyun Application Pioneering Project,No.FY-APP-ZX-2023.02。
文摘Water use efficiency(WUE),as a pivotal indicator of the coupling degree within the carbon–water cycle of ecosystems,holds considerable importance in assessment of the carbon–water balance within terrestrial ecosystems.However,in the context of global warming,WUE evolution and its primary drivers on the Tibetan Plateau remain unclear.This study employed the ensemble empirical mode decomposition method and the random forest algorithm to decipher the nonlinear trends and drivers of WUE on the Tibetan Plateau in 2001–2020.Results indicated an annual mean WUE of 0.8088 gC/mm·m^(2)across the plateau,with a spatial gradient reflecting decrease from the southeast toward the northwest.Areas manifesting monotonous trends of increase or decrease in WUE accounted for 23.64%and 9.69%of the total,respectively.Remarkably,66.67%of the region exhibited trend reversals,i.e.,39.94%of the area of the Tibetan Plateau showed transition from a trend of increase to a trend of decrease,and 26.73%of the area demonstrated a shift from a trend of decrease to a trend of increase.Environmental factors accounted for 70.79%of the variability in WUE.The leaf area index and temperature served as the major driving forces of WUE variation.
文摘BACKGROUND The development of hepatocellular carcinoma(HCC)is influenced by multiple factors.Interventional therapy offers an effective treatment option for patients with unresectable intermediate-to-advanced HCC.Interventional therapy can induce electrocardiographic(ECG)abnormalities that may be associated with liver dysfunction,electrolyte disorders,and cardiac injury.AIM To explore the ECG alterations and determinants following interventional therapy in patients with HCC.METHODS Sixty patients undergoing interventional treatment for liver cancer were selected as study participants.According to the results of the dynamic ECG examination 1 day after surgery,the patients were divided into an abnormal group(n=21)and a nonabnormal group(n=39).With the help of dynamic ECG examination,the ECG parameters were compared and the baseline data of patients was recorded in the two groups.RESULTS The 24 hours QT interval variability,24 hours normal atrial polarization to ventricular polarization(R-R)interval(standard deviation),24 hours consecutive 5 minutes normal R-R interval,and 24 hours continuous 5 minutes normal R-R interval(standard deviation mean)were lower than patients in the nonabnormal group(P<0.05).The logistic analysis showed that age>60 years,liver function grade B,and postoperative body temperature 38°C were risk factors for abnormal dynamic electrocardiogram in patients with liver cancer intervention(P<0.05).CONCLUSION Interventional therapy for HCC can lead to ECG abnormalities,underscoring the clinical need for enhanced cardiac monitoring to mitigate myocardial complications.
基金Supported by General Projects of Henan Province Universities Humanities and Social Sciences Research in 2023,No.2023-ZDJH-533.
文摘BACKGROUND China has recently encountered severe challenges associated with population aging.Parents of first-generation only children face significant challenges regarding elderly care needs and the associated negative emotions.AIM To analyze the elderly care needs of first-generation only child parents in China and identify factors that influence negative emotions.METHODS This study used a cross-sectional design.Convenience sampling was used to select 1580 elderly individuals who met the inclusion criteria in a Chinese city between June and September 2022.A questionnaire was administered to collect general information about participants.Depression and anxiety were assessed using the patient health questionnaire-9 and generalized anxiety disorder-7 scale,respectively.A logistic regression analysis was performed to evaluate the relevant correlations.RESULTS Among 1580 first-generation only child parents,1120(70.89%)preferred family based care,324(20.51%)opted for community care,and 136(8.61%)chose institutional care,with 460(29.11%)reporting negative emotions.Significant differences in the distribution of negative emotions among only child parents were observed based on age,marital status,living conditions,disability,type of chronic disease,frailty status,and family support(P<0.05).The regression analysis indicated that disability,type of chronic disease,living environment,frailty status,and level of family support were independent risk factors for negative emotions among parents with only children(P<0.05).CONCLUSION Elderly care for parents of only children is primarily family-based.Independent risk factors for negative emotions in this group include disability,chronic disease type,and living environment.
文摘Thyroid cancer is a common endocrine malignancy with a rising incidence.Pa-tients often suffer from mental pain due to concerns about recurrence,treatment-related side-effect,and body image changes.Demographic factors like age,gender,physiological factors such as somatic symptoms and disease stage,co-gnitive-regulatory factors including negative and positive thinking,and social factors like work,economy,education level,and social support all influence their mental state.Existing interventions,including nursing,psychological,and tra-ditional Chinese medicine-based methods,have some benefits but face limitations like short-term effectiveness and lack of standardization.Future research should focus on creating better-defined,long-term,and widely applicable intervention programs and explore positive psychology-based approaches to improve patients'mental well-being and quality of life.
文摘BACKGROUND Patients with middle and advanced hepatocellular carcinoma(HCC)frequently experience significant anxiety and depression,severely affecting their quality of life.AIM To examine the anxiety and depression status of patients with middle and advanced HCC,the influencing factors,and the correlation between these psychological factors and quality of life.METHODS We collected baseline data from 100 patients with HCC,assessing anxiety and depression levels using the Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD).Quality of life was evaluated with the Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire.Multivariate logistic regression analyzed clinical and psychosocial factors affecting anxiety and depression,while Pearson correlation assessed relationships among HAMA,HAMD,and Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire scores.RESULTS Results indicated that 64%of patients exhibited anxiety and 65%showed depression symptoms.Key influencing factors included Barcelona Clinic Liver Cancer C stage,multiple tumors,social support,prior treatments(such as liver resection and transcatheter arterial chemoembolization/hepatic artery infusion chemotherapy),as well as HAMA and HAMD scores.Anxiety and depression correlated negatively with quality of life,with coefficients of-0.671 and-0.575 for HAMA and HAMD,respectively.CONCLUSION Anxiety and depression are prevalent among patients with middle and advanced HCC,impacting quality of life.This underscores the need for psychological health considerations in liver cancer treatment and establishing psychological interventions is essential.
基金supported by the Sichuan Province Nursing Scientific Research Project Plan(H23022)the 2022 Municipal-University Science and Technology Strategic Cooperation Special Fund of Nanchong Science and Technology Bureau(22SXQT0222)。
文摘Objective Accurately identifying the key influencing factors of psychological birth trauma in primiparous women is crucial for implementing effective preventive and intervention measures.This study aimed to develop and validate an interpretable machine learning prediction model for identifying the key influencing factors of psychological birth trauma in primiparous women.Methods A multicenter cross-sectional study was conducted on primiparous women in four tertiary hospitals in Sichuan Province,southwestern China,from December 2023 to March 2024.The Childbirth Trauma Index was used in assessing psychological birth trauma in primiparous women.Data were collected and randomly divided into a training set(80%,n=289)and a testing set(20%,n=73).Six different machine learning models were trained and tested.Training and prediction were conducted using six machine learning models included Linear Regression,Support Vector Regression,Multilayer Perceptron Regression,eXtreme Gradient Boosting Regression,Random Forest Regression,and Adaptive Boosting Regression.The optimal model was selected based on various performance metrics,and its predictive results were interpreted using SHapley Additive exPlanations(SHAP)and accumulated local effects(ALE).Results Among the six machine learning models,the Multilayer Perceptron Regression model exhibited the best overall performance in the testing set(MAE=3.977,MSE=24.832,R2=0.507,EVS=0.524,RMSE=4.983).In the testing set,the R2 and EVS of the Multilayer Perceptron Regression model increased by 8.3%and 1.2%,respectively,compared to the traditional linear regression model.Meanwhile,the MAE,MSE,and RMSE decreased by 0.4%,7.3%,and 3.7%,respectively,compared to the traditional linear regression model.The SHAP analysis indicated that intrapartum pain,anxiety,postpartum pain,resilience,and planned pregnancy are the most critical influencing factors of psychological birth trauma in primiparous women.The ALE analysis indicated that higher intrapartum pain,anxiety,and postpartum pain scores are risk factors,while higher resilience scores are protective factors.Conclusions Interpretable machine learning prediction models can identify the key influencing factors of psychological birth trauma in primiparous women.SHAP and ALE analyses based on the Multilayer Perceptron Regression model can help healthcare providers understand the complex decision-making logic within a prediction model.This study provides a scientific basis for the early prevention and personalized intervention of psychological birth trauma in primiparous women.
文摘This paper thoroughly explores the multifaceted factors influencing the efficacy of Chinese medicinals and categorizes them into three main groups:medicinal related factors,patient related factors,and practitioner related factors.Regarding medicinal related factors,the place of origin,growing environment,harvesting time,storage conditions,quality control,dosage form selection,compatibility of medicinals,precise dosing,decoction methods,and administration routes all significantly impact efficacy.The place of origin determines the authenticity of medicinals,the growing environment affects their composition,harvesting time influences potency,improper storage leads to deterioration,quality control forms the foundation of efficacy,dosage forms and compatibility of medicinals affect absorption,dosing and decoction methods require precision,and administration routes should be tailored to individuals.Patient related factors include psychological state,individual differences,background,and disease condition.Psychological state affects treatment compliance,individual differences determine medicine responses,background influences patients’understanding of Chinese medicinals,and disease condition directly reflects efficacy.Practitioner related factors encompass theoretical knowledge,clinical experience,inherited practices,psychological state,and professional ethics.Theoretical knowledge guides medication use,clinical experience enhances efficacy,inherited practices influence prescribing styles,psychological state affects doctor–patient communication,and professional ethics ensure medical quality.These interrelated factors collectively influence the efficacy of Chinese medicinals,emphasizing the need for comprehensive consideration in clinical applications to achieve optimal therapeutic outcomes.
文摘Cross-border e-commerce,as a new form of international trade,has shown great development potential in the context of the“Belt and Road”initiative.Based on the cross-border e-commerce export data from 2015 to 2024,this paper analyzes the influencing factors of China's cross-border e-commerce exports to countries along the“Belt and Road”by constructing an econometric model.The study found that factors such as the perfection of digital infrastructure,the efficiency of logistics and transportation,the convenience of payment and settlement,and the penetration rate of consumers online shopping significantly affect the export scale of cross-border e-commerce.Institutional factors such as the development level of e-commerce platforms in countries along the route,market access thresholds,and tariff policies also play an important role.Based on the research results,suggestions are put forward to strengthen the construction of cross-border payment system,optimize the logistics distribution network,promote customs clearance facilitation,and deepen cooperation in the field of e-commerce,to provide references for promoting the development of China's crossborder e-commerce exports to countries along the“Belt and Road.”
文摘[Objectives]To study the factors influencing the tourism economy in Henan Province.[Methods]Using tourism-related data from Henan Province covering the period from 2000 to 2020,this study constructs a regression model based on multivariate statistical methods to investigate the determinants of the tourism economy.The dependent variable in the model is the domestic tourism revenue of Henan Province,while the independent variables comprise the number of tourist arrivals,total operational railway mileage,the number of travel agencies,and the per capita disposable income of urban residents.[Results]Both the total railway mileage and the per capita disposable income of urban residents are the primary factors influencing the development of Henan's tourism economy.[Conclusions]It is recommended to reduce uncertainty and liquidity constraints to mitigate residents'precautionary savings behavior,actively expand domestic demand to leverage tourism as an economic driver,and improve infrastructure to support tourism development.
文摘Based on questionnaire data from Niutouzhen Village Units 1-7 in Shuangwangcheng Economic Zone,Shouguang City,Shandong Province,this study employs a binary logistic regression model to explore the factors influencing farmers'willingness to transfer farmland,and uses SPSS 27.0 software to perform regression analysis on the data.The results indicate that farmers'educational level,age of the household head,and contracted land area have a positive influence on farmers'willingness to transfer farmland at the 0.05 significance level,while annual household income has a positive influence at the 0.10 significance level.Furthermore,based on the regression analysis results,measures are proposed,including establishing and improving the rural land transfer compensation mechanism,enhancing publicity for land transfer,refining land transfer laws and regulations,optimizing the rural social security system,and actively expanding non-agricultural employment channels.These measures are intended to provide references for promoting farmland transfer work in Shouguang City.
基金supported by the Science and Technology Research Project and funded by the Provincial-Ministry Co-construction Project(No.SBGJ202102186).
文摘Objective:To explore the barriers and facilitators associated with the implementation of horticultural activities(HA)in nursing care homes,and aim to identify findings that will enhance the development of more effective implementation strategies for such activities.Methods:This qualitative descriptive study recruited a purposive sample of potential adopters related to HA in nursing care homes,and the conventional content analysis method was adopted.Results:A total of 6 older adults,3 social workers,1 nurse,and 1 physician participated in this study.The analysis revealed 4 themes barriers and 2 themes facilitators to the implementation of HA.Conclusions:Future intervention programs should be meticulously designed to address the identified influencing factors,and the insights gained can serve as a reference for identifying and mitigating barriers in the implementation of other physical activity programs.In turn,this will contribute to improved physical functioning and healthy aging.
基金Soft Science Special Project of Gansu Basic Research Plan,No.25JRZA072Youth Project of Philosophy and Social Science Foundation of Gansu Province,No.2024QN015+1 种基金General Project of Philosophy and Social Science Foundation of Gansu Province,No.2024YB049Lanzhou Philosophy and Social Science Planning Project,No.24-B13.
文摘Adolescence is a crucial period marked by significant developmental changes,during which risk-taking behaviors can be both a normative part of development and a potential source of concern.However,prior research has focused predominantly on the adverse aspects of risk-taking(i.e.,negative risk-taking),overlooked the positive counterpart(i.e.,positive risk-taking),and lacked a detailed examination of both.This study aims to elucidate the distinct characteristics and interrelationships of positive and negative risk-taking behaviors among adoles-cents and to identify the key factors that influence these behaviors.Through a comprehensive synthesis of theoretical and empirical literature,we explore the multifaceted nature of risk-taking,highlighting its complex influencing factors,including individual traits,family dynamics,peer influence,school environment,and broader community contexts.By identifying the shared and unique factors contributing to positive and negative risk-taking behaviors,we can enable adolescents to navigate this complex stage of life and design targeted interventions.Future research directions include the application of person-centered approaches,the implementation of longitudinal tracking and the interactive effects of influencing factors,among other aspects.
文摘BACKGROUND Glaucoma,a condition frequently linked to severe depression,anxiety,and sleep disturbances,affects treatment adherence while potentially compromising effectiveness.AIM To explore illness uncertainty(IU),anxiety,and depressive symptoms in primary glaucoma and to discuss underlying triggers.METHODS We recruited 120 primary glaucoma cases between January 2022 and November 2023.The Mishel Uncertainty in Illness Scale(MUIS)and the Hospital Anxiety and Depression Scale(HADS)[include HADS-anxiety subscale(HADS-A)and HADS-depression subscale(HADS-D)]subscales,were used to assess IU and emotional distress(anxiety/depression),respectively.The MUIS-HADS subscale interrelationships were determined by Pearson correlation.IU-associated determinants were identified using univariate and binary logistic regression analyses.RESULTS The cohort showed a mean MUIS score of 79.73±8.97,corresponding to a moderately high IU level.The HADS-A and HADS-D scores averaged 6.57±3.89 and 7.08±5.05 points,respectively,with 15.00%of participants showing anxiety symptoms and 24.17%exhibiting depressive signs.Significant positive connections were observed between MUIS and both HADS-A(r=0.359,P<0.001)and HADSD(r=0.426,P<0.001).Univariate analysis revealed that disease duration,insomnia,monthly household income per capita,and the presence of comorbid chronic conditions were significantly associated with anxiety or depression.Multivariate analysis identified insomnia as a risk factor and higher monthly household income as a protective factor.CONCLUSION Patients with primary glaucoma experience moderate IU levels,generally low anxiety,and mild depression.Specifically,the anxiety and depression risks were 15.00%and 24.17%,respectively.A significant positive correlation existed between IU and anxiety/depression in these patients.Additionally,insomnia or lower monthly household income elevated anxiety/depression risks,enabling reliable anxiety/depression risk categorization among patients.
