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
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
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
Objectives:To assess job satisfaction among anesthesia graduates working in various medical institutions across China.Methods:A cross-sectional survey was conducted,collecting demographic information,Minnesota Satisfa...Objectives:To assess job satisfaction among anesthesia graduates working in various medical institutions across China.Methods:A cross-sectional survey was conducted,collecting demographic information,Minnesota Satisfaction Questionnaire scores,work pressure,and turnover intentions.Multiple linear regression analysis was used to examine factors influencing job satisfaction.The electronic survey was distributed to Chinese anesthesia graduates from December 2021 to January 2022.Results:A total of 595 questionnaires were distributed,with 318 valid responses,resulting in a response rate of 53.4%.The participants’overall job satisfaction score on the Minnesota Satisfaction Questionnaire was 75.85±12.57.Multiple linear regression analysis identified the following variables as significantly associated with job satisfaction:age,daily working hours,income,current position,and work pressure.Conclusions:Anesthesia graduates in China reported slightly higher-than-average overall job satisfaction.However,several issues remain.Attention should be given to the impact of factors such as youth,long working hours,low income,current position,and high work pressure on job satisfaction.The government should support anesthesiologists with improved training,job security,and benefits to enhance job satisfaction.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
BACKGROUND Intellectual disability(ID),affecting 1%-3%of children globally,presents significant challenges for parents that often translate into occupational stress.While studies document elevated parenting stress lev...BACKGROUND Intellectual disability(ID),affecting 1%-3%of children globally,presents significant challenges for parents that often translate into occupational stress.While studies document elevated parenting stress levels(33.57 vs 26.46 in controls),job-related impacts remain poorly understood.This study employs propensity score matching(PSM)to rigorously analyze work stress determinants among parents of preschool-aged children with ID,controlling for socioeconomic and behavioral confounders.The research bridges a critical gap by examining how workplace demands intersect with special caregiving responsibilities,aiming to identify modifiable risk factors for targeted interventions.Findings will inform evidence-based workplace accommodations and support policies,offering novel insights into the occupational consequences of parenting a child with ID through advanced causal inference methods.This work holds important implications for hazard ratio(HR)policies and social support systems serving this vulnerable population.AIM To explore the factors affecting the job stress of parents of preschool children with mental retardation(MR),based on the PSM.METHODS One hundred and twenty-five children aged 3-6 years who were treated in our hospital from December 2022 to December 2024 were included in the questionnaire survey.Five cases were excluded due to incomplete data,and 120 cases completed the study.The questionnaire was filled out by the parents of the children,and 100 parents of normal children were selected to be included in the control group.After the baseline difference was balanced by PSM 1:1 matching,the general information,scores of parental stress in each dimension and parental stress level of the two groups were compared and analyzed.Single factor analysis was carried out on the factors affecting the parental stress of group;Pearson was used to analyze the correlation between the factors affecting parental stress in MR group.Logistic regression was used to analyze the factors affecting the job stress of parents in MR group.RESULTS After matching,there were 97 cases in both groups.The differences of parents'working status and family location in MR group were statistically significant,P<0.05.Parents in MR group were significantly higher than those in control group in every dimension and total score,of which 75.22%were at a high level,P<0.05.Univariate analysis shows that the older the parents are,the more unstable their work status is,the lower their education level is,the less their family income is,their location is in the countryside and the children have a genetic history,the higher their parental stress score is.Pearson correlation analysis showed that the total score of parental stress was related to supporting friends(r=-0.354),seeking social support,maintaining self-esteem and psychological stability(r=-0.146),coping style frequency(r=-0.476)and role size(r=-0.063).P<0.05.Using the binary Logistic regression model,it was found that whether the child had a genetic history(HR=1.667)was a risk factor affecting the parents'job stress of MR children,and friends'support(HR=0.539),seeking social support(HR=0.478),maintaining self-esteem and psychological stability(HR=0.625),and the frequency and role of coping styles(HR=0.794)were all its protective factors,P<0.05.CONCLUSION Parents'parental stress of most preschool children with MR is at a high level,in which children's genetic history is its risk factor,and friends'support,seeking social support,maintaining self-esteem and psychological stability,as well as the frequency and role of coping styles are its protective factors,which provides new intervention programs and measures to alleviate parents'parental stress of MR children.展开更多
BACKGROUND The development of prostate cancer(PC)frequently intensifies negative emotional states,such as anxiety and depression,which compromise the effectiveness of radical surgery and reduce treatment adherence.In ...BACKGROUND The development of prostate cancer(PC)frequently intensifies negative emotional states,such as anxiety and depression,which compromise the effectiveness of radical surgery and reduce treatment adherence.In this study,we hypothesized that psychological resilience plays a crucial role in this process and explored its impact.AIM To investigate the association of resilience with anxiety and depression in patients with PC and to analyze the influencing factors.METHODS We selected 147 patients with PC who visited Qingdao Traditional Chinese Medicine Hospital from January 2022 to June 2024.The resilience scores of patients with PC were assessed using the Connor-Davidson Resilience Scale(CDRISC)from the tenacity,self-improvement,and optimism dimensions.Based on the total CD-RISC score,patients were categorized into groups A(total CD-RISC score>63 points,n=69)and B(total CD-RISC score≤63 points,n=78)for comparative analysis of anxiety[Hamilton Anxiety Rating Scale(HAMA)],depression[Hamilton Depression Rating Scale(HAMD)],sexual function[International Index of Erectile Function-5(IIEF-5)and Sexual Life Quality Questionnaire-Quality of Life(SLQQ-QOL)],and quality of life[the EORTC Core Quality of Life Question naire(QLQ-C30)].The association between CD-RISC and the above indicators was analyzed with Spearman correlation coefficients,and the influencing factors of resilience in patients with PC were identified with binary logistic regression.RESULTS Group A demonstrated statistically lower HAMA and HAMD scores and markedly higher scores of IIEF-5,SLQQQOL,and various QLQ-C30 aspects.Correlation analysis revealed that CD-RISC was significantly negatively correlated with HAMA and HAMD scores and significantly positively correlated with IIEF-5,SLQQ-QOL,and QLQ-C30 total scores.Binary logistic regression analysis revealed educational and per capita monthly household income levels as significant influencing factors of resilience in patients with PC.CONCLUSION Our results indicate a significant correlation of resilience with anxiety and depression in patients with PC.The milder the anxiety and depression emotions in patients,the higher their resilience.Further,assisting patients with PC to improve their educational and per capita monthly household income levels will help their resilience to some extent.展开更多
Research on urban health constitutes an important issue in the field of health geography and also a strong propeller of the Healthy China Initiative.As the main form that realizes new-type urbanization,urban agglomera...Research on urban health constitutes an important issue in the field of health geography and also a strong propeller of the Healthy China Initiative.As the main form that realizes new-type urbanization,urban agglomerations should become the primal sites for the construction of a“Healthy China”.The evaluation of healthy cities’development in urban agglomerations has both theoretical and practical values.Based on the concept of urban health and its evaluation models,this paper developed an evaluation framework for healthy cities that involved multiple data sources.With 19 urban agglomerations in China as the research subjects,we used CRITIC weighting and geographical detectors to examine the geographies of healthy cities and their influencing factors in 2010 and 2020.The results were fourfold.Firstly,the urban health level of China significantly increased from 2010 to 2020,and the comprehensive health index developed towards a positive skewed distribution,along with a shift from“low in the hinterland-high in the coastal areas”to a“multipolar”pattern led by the coastal and southwest urban agglomerations.Secondly,among various dimensions of urban health,the healthy environment index became improved with narrowed regional differences;while the health services index was still polarized;health collaboration was upgraded with a strengthened intercity health network;the healthy population index slightly declined and converged to the middle.Thirdly,urban health in China has initially demonstrated the characteristics of a H-H pattern in the Yangtze River Delta and ChengduChongqing regions,as well as L-L clusters in the northern urban agglomerations,the narrowed regional differences,and increasing coordination within each urban agglomeration.Fourthly,the geographical detector found that economy,urbanization and the human capital were significant external factors that affected urban health development.The explanatory power of technological innovation and opening to the outside world were also increasing.The development of healthy cities is yet to be transformed into regional health integration.展开更多
With the accelerated pace of population aging in China,the number of patients suffering from myocardial infarction(MI)is increasing annually.During disease progression,patients are at significantly higher risk of deve...With the accelerated pace of population aging in China,the number of patients suffering from myocardial infarction(MI)is increasing annually.During disease progression,patients are at significantly higher risk of developing severe negative emotions,and emerging evidence suggests that post-traumatic stress disorder(PTSD)is significantly associated with cardiovascular disease,which seriously affects patients’quality of life.Objective:The aim of this study was to comprehensively assess the prevalence and influencing factors of PTSD in MI patients through systematic review and Meta-analysis.Methods:A computerized search of PubMed,the Cochrane Library,Embase,Web of Science,PsycINFO,China Knowledge Network(CNKI),WanFang Data,VIP,and China Biomedical Literature Database(CBM)was conducted to collect longitudinal studies,case-control studies,and cross-sectional studies related to PTSD prevalence rates and influencing factors in MI patients published up to August 1,2024.Literature screening,data extraction and quality assessment were done independently by two researchers and Meta-analysis was done using Stata 16.0 software.This study has been registered on the PROSPERO platform,registration number:CRD42024577243.Results:A total of 16 papers were included,with a total sample size of 3,768 cases involving 8 influencing factors.The results of the Meta-analysis showed that the prevalence of PTSD in patients with MI was 20.4%(95%CI=15.0–26.5%).Female(OR=3.12,95%CI=1.97–4.97,P<0.001),high neuroticism score(OR=2.21,95%CI=1.20–4.07,P=0.011),and high intrusive rumination score(OR=2.95,95%CI=1.50–5.83,P=0.002)were the risk factors for PTSD in MI patients.While age(OR=1.01,95%CI=0.98–1.04,P=0.440),education level(OR=0.55,95%CI=0.07–4.48,P=0.574),social support rating scale(OR=0.81,95%CI=0.52–1.26,P=0.346),Killip cardiac function classification(OR=2.29,95%CI=0.91–5.80,P=0.080)and creatine kinase isoenzyme(OR=1.03,95%CI=0.99–1.05,P=0.124)were not associated with the development of PTSD in MI patients.Conclusion:The prevalence of PTSD was higher in patients with MI.The prevalence varied by evaluation tool and study area.Risk factors were multifactorial,including general factors(female)and overall assessment(high neuroticism score,high invasive rumination score).Therefore,early intervention and proper de-escalation of PTSD symptoms in patients with MI by medical staff are needed in clinical practice to reduce the risk of PTSD.展开更多
BACKGROUND Post-stroke depression(PSD),a condition commonly developed in patients with chronic stroke,impairs both functional rehabilitation and daily living.AIM To comprehensively analyze PSD contributors in chronic ...BACKGROUND Post-stroke depression(PSD),a condition commonly developed in patients with chronic stroke,impairs both functional rehabilitation and daily living.AIM To comprehensively analyze PSD contributors in chronic phase stroke and construct a precise nomogram.METHODS Two hundred patients with chronic stroke admitted in over 7 years(January 2017 to January 2024),were enrolled and categorized into the PSD group(n=96)and the non-PSD(NPSD)group(n=104).Demographic characteristics,clinicopathological data,and biochemical indicators were collected and analyzed by univariate analysis.Significant predictors identified in the univariate analysis were subsequently incorporated into a binary logistic regression model to assess their independent effects on PSD risk.The discriminative ability/calibration of the developed PSD prediction nomogram was assessed.RESULTS Compared with the NPSD group,the PSD group included a higher proportion of patients aged≥60 years,divorced/widowed,with an education level below senior high school,presenting with≥2 comorbidities,exhibiting severe neurological impairment,and having multiple lesions.Additionally,the PSD group showed significantly higher neutrophil-to-lymphocyte ratio(NLR)and platelet-tolymphocyte ratio(PLR)than the NPSD group.After assigning values to significant predictors,multivariate analysis indicated that educational level(P=0.046),NLR(P<0.001),and PLR(P<0.001)were independently associated with PSD in patients with chronic stroke.The developed nomogram exhibited favorable discrimination performance.The nomogram's calibration remained accurate for high-risk stratification but displayed modest inconsistencies in lowand middle-risk categories.CONCLUSION Education level,NLR,and PLR independently contribute to PSD in patients with chronic stroke.The constructed nomogram effectively predicts PSD risk within the range of 0.10-0.90,presenting a valuable tool for clinical monitoring and risk assessment of PSD in patients with chronic stroke.展开更多
Objectives:The study aimed to survey the current situation and explore the factors that influence the ability of palliative care practice among oncology nurses.Methods:A multicenter cross-sectional study was conducted...Objectives:The study aimed to survey the current situation and explore the factors that influence the ability of palliative care practice among oncology nurses.Methods:A multicenter cross-sectional study was conducted using stratified random sampling to select 26 tertiary hospitals’oncology departments in Hubei Province,China.A total of 1,198 nurses were included and finished the questionnaire consisting of social demographic characteristics,Palliative Care Self-Report Practice Scale(PCPS),End-of-life Professional Caregiver Survey(EPCS),and Self-Perceived Pain Assessment Knowledge and Confidence Scale(Self-PAC)through the online platform.Data were analyzed using t-test,one-way ANOVA,Pearson correlation analysis,and multiple linear regression analysis in SPSS 26.0.Results:The total score for PCPS was 67.17±12.57,the three dimensions’scores were:physical symptom care(32.50±6.10),spiritual and psychological care(23.35±4.97),communication(11.58±2.48).There are significant positive correlations between the palliative care practice ability and core competence(r=0.77,P<0.01),as well as pain assessment ability(r=0.56,P<0.01).Multiple regression analysis identified female,with high education background(bachelor’s degree and master’s degree or above),interest in palliative care,pain assessment ability,and core competence were positive predictors of palliative care practice ability(Adjusted R^(2)=0.668,P<0.05).Conclusions:The overall ability of the oncology nurses to practice palliative care was relatively high,but the palliative nurses reported suboptimal performance in the communication dimension of palliative nursing practice ability.To comprehensively improve oncology nurses’palliative care practice ability,managers must consider the gender structure,educational background,enthusiasm for palliative care work,core competence,and pain assessment ability.展开更多
BACKGROUND In cases of colorectal cancer(CRC)with obstruction,patients experience local tissue edema due to intestinal obstruction.This condition stimulates the accumulation of inflammatory factors,activates cancer ce...BACKGROUND In cases of colorectal cancer(CRC)with obstruction,patients experience local tissue edema due to intestinal obstruction.This condition stimulates the accumulation of inflammatory factors,activates cancer cells,and increases the risk of tumor recurrence.At present,analyses and evaluation tools for factors influencing early postoperative recurrence in patients with CRC and obstruction are limited.AIM To explore the influencing factors and construct a predictive model of the early postoperative recurrence of CRC with obstruction.METHODS Data from 181 patients with CRC and obstruction who underwent surgery in the Department of Gastrointestinal Surgery,Suzhou Ninth Hospital Affiliated to Soochow University,between January 2017 and May 2023 were retrospectively collected.Patients with CRC and obstruction were divided into a recurrence group and a non-recurrence group based on whether recurrence occurred during the 2-year follow-up after surgery.Datasets from the two groups were compared.Subsequently,multiple logistic regression was employed to analyze the influencing factors of the early postoperative recurrence of CRC with obstruction.The nomogram prediction model was drawn using R software,and its performance was evaluated by the goodness of fit test and receiver operating characteristic(ROC)curve analysis.The clinical benefit rate of the model was evaluated by decision curves.RESULTS Among the 181 patients with CRC and obstruction,52(28.73%)experienced tumor recurrence within 2 years after surgery.Significant differences were observed in preoperative carcinoembryonic antigen(CEA),preoperative systemic immuneinflammation index(SII),tumor,node,and metastasis(TNM)stage,differentiation degree,nerve infiltration,and Ki-67 expression between the recurrence and non-recurrence groups(P<0.05).Multivariate logistic regression analysis showed that high preoperative CEA(OR=2.094,P=0.008),high preoperative SII(OR=2.795,P<0.001),TNM stage III(OR=1.644,P=0.027),poor differentiation(OR=1.861,P=0.035),and high Ki-67 expression(OR=2.467,P=0.001)were all influencing factors for early postoperative recurrence of CRC with obstruction.The area under the ROC curve of the nomograph model constructed based on this was 0.890,the goodness of fit deviation test was conducted(χ^(2)=3.903,P=0.866),and the decision curve display model demonstrated practical value in clinical practice.CONCLUSION The early recurrence rate of CRC with obstruction is high.CEA,SII,TNM staging,differentiation degree,and Ki-67 expression are factors related to early postoperative recurrence.A nomogram prediction model incorporating these factors can effectively evaluate the risk of early postoperative recurrence in patients with CRC.展开更多
To investigate the distribution characteristics and influencing factors of bicycle detour behavior,this study ac-curately identified detour behavior using global positioning system(GPS)track data from shared bicycles....To investigate the distribution characteristics and influencing factors of bicycle detour behavior,this study ac-curately identified detour behavior using global positioning system(GPS)track data from shared bicycles.Factors such as travel time,road conditions,public transportation facilities,and land use types were considered in constructing a detour behavior influence model based on the CatBoost machine learning algorithm.The interpretability of the machine learning framework was enhanced via Shapley additive explanations(SHAP),enabling an analysis of the impact of each factor on detour behavior.The results indicated that the CatBoost model effectively recognized detour behavior with high accuracy.The frequency of detour behavior increased with higher road levels,greater distances to crossing facilities,wider bike lanes,and an increased number of bus stops,subway stations,and leisure and entertainment facilities,while it decreased with a higher number of office commuting facilities.In addition,detour behavior was more prevalent on weekends,during off-peak hours,and under conditions involving physical central lane separation and physical bike lane separation.These findings offer a novel approach for identifying bicycle riding behaviors and analyzing their influencing factors,providing effective technical support for non-motorized traffic management and infrastructure optimization.展开更多
Agriculture holds a pivotal position in the economic fabric of every nation,yet concerns about agricultural carbon emission intensity(ACI)have become a major hurdle to achieving global economic sustainability.Focusing...Agriculture holds a pivotal position in the economic fabric of every nation,yet concerns about agricultural carbon emission intensity(ACI)have become a major hurdle to achieving global economic sustainability.Focusing on 31 provincial-level regions in China,this study uses the Exploratory Spatio-temporal Data Analysis(ESTDA)and Panel Quantile Regression(PQR)model to analyze the spatio-temporal interaction characteristics and influencing factors of ACI in China from 2004 to 2023.The findings are as follows:(1)ACI showed an overall downward trend,and the spatial distribution pattern was characterized by“high in the western region and low along the southeastern coast”.Although the overall disparity tended to converge,some high-carbon-intensity regions exhibited extreme trends.ACI displayed clear spatial directionality,with the spatial center shifting steadily toward the northeast.(2)Regions in the northwest,northeast,and central-south parts exhibited strong local spatial structural dynamics,and the local spatial dependence of ACI in each region showed a nonlinear trend.Generally speaking,the spatial association pattern demonstrated a certain degree of inertia in spatial transfer,reflecting strong path dependence or spatial lock-in characteristics.(3)Optimization of industrial structure and improvement in agricultural mechanization will increase ACI,while economic development can effectively reduce it.The impact of urbanization on ACI exhibits a nonlinear pattern.The coordinated development of economic growth and urbanization significantly reduces ACI,with a stronger emission reduction observed in regions with low ACI.The optimization of industrial structure,when combined with urbanization and environmental regulation,contributes to significant emission reductions particularly in high-ACI areas.Similarly,the synergy between agricultural mechanization and urbanization effectively lowers emissions in low-ACI regions,though this effect diminishes in areas with higher ACI.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 The prevalence and severity of noncommunicable chronic diseases(NCDs)among Chinese residents have been increasing with mental health emerging as a critical challenge in disease management.AIM To examine the...BACKGROUND The prevalence and severity of noncommunicable chronic diseases(NCDs)among Chinese residents have been increasing with mental health emerging as a critical challenge in disease management.AIM To examine the interactions between depression,anxiety symptoms,and related factors,and to identify key factors in the Chinese population with NCDs.METHODS Data from the Psychology and Behavior Investigation of Chinese Residents were used in a cross-sectional survey of 6182 individuals with NCDs.This study measured depression and anxiety symptoms as well as their influencing factorsincluding social environments,individual behaviors and lifestyles,and subjective indicators.A network analysis approach was used for data assessment.RESULTS Network analysis demonstrated that several central factors(media exposure,family health,problematic internet use,suboptimal health status,intimate relationship violence,tired or little energy,and nervousness/anxious/on edge)and bridge factors(media exposure,problematic internet use,intimate partner violence,health literacy,and suboptimal health status)that significantly influenced the co-occurrence and interconnectedness of depression and anxiety symptoms.Additionally,gender,ethnicity,residency,and living status did not significantly influence the overall network strength.CONCLUSION Depression and anxiety are prevalent among the Chinese population with NCDs.Effective interventions should focus on managing key symptoms,promoting correct media use for health information,and fostering healthier family relationships.展开更多
BACKGROUND Colorectal cancer(CRC)is a common malignant tumor in the digestive system,whose main treatment comprises surgical resection,radiotherapy and chemotherapy,and targeted drug therapy.At present,the radical res...BACKGROUND Colorectal cancer(CRC)is a common malignant tumor in the digestive system,whose main treatment comprises surgical resection,radiotherapy and chemotherapy,and targeted drug therapy.At present,the radical resection of CRC is the main way of achieving an early cure.AIM To investigate the logistic regression analysis of bone metastasis after CRC surgery and related influencing factors.METHODS We selected 100 patients who underwent surgery for CRC and were admitted from February 2018 to February 2024,collected the general data of bone metastasis,and collected the pathological characteristics of patients with bone metastasis.Next,we divided them into groups with and without bone metastasis(Bone metastases group,n=44;no bone metastases group,n=56),compared the clinical data of the two groups,and analyzed the risk factors of bone metastasis using logistic regression analysis.RESULTS Among the 100 patients,the mean age was 54.33±8.45 years,and most were male(54.55%).The proportion of patients with lytic bone changes was 43.18%.The most common location of combined bone metastasis was the pelvis,whereas only 5 patients had limb transfer.There was a higher incidence of lung than of pancreatic or liver metastases.Regression analysis showed that the primary location of the cancer was rectal cancer.Lymph node involvement,lung metastasis,and no postoperative chemotherapy were the risk factors for postoperative bone metastasis in patients who underwent surgery for CRC(P<0.05).CONCLUSION Rectal cancer,lymph node involvement,complicated pulmonary metastasis,and no postoperative chemotherapy treatment can help predict high risk of bone metastasis in CRC.展开更多
Sloping farmland,particularly in mountainous and hilly areas,constitutes a significant component of regional farmland resources.An investigation into the spatio-temporal pattern of sloping farmland and its influencing...Sloping farmland,particularly in mountainous and hilly areas,constitutes a significant component of regional farmland resources.An investigation into the spatio-temporal pattern of sloping farmland and its influencing factors in China is imperative for the efficient utilization of farmland and the optimization of land space.We used land use transfer matrix,geographically weighted regression model and geographical detector to conduct this study.Results showed that sloping farmland in China firstly decreased and then increased from 2000 to 2020.The proportion of sloping farmland decreased radially outward from Sichuan basin to the surrounding areas.Change rates of sloping farmland with different slopes varied and the slope with 6°-15°underwent the fastest changes.The influencing factors of farmland at various slope degrees were different.For sloping farmland below 15°,land use intensity and elevation had the greatest contribution.For sloping farmland between 15°and 25°,elevation,land use intensity,and population density were the main influencing factors.Sloping farmland above 25°was mostly affected by natural factors.This study can provide scientific basis for rational development and protection of sloping farmland.展开更多
Background and Purpose: In recent years, individual spirituality has been attracting attention, but little research has been conducted as it relates to family spirituality that applies this concept to the family and r...Background and Purpose: In recent years, individual spirituality has been attracting attention, but little research has been conducted as it relates to family spirituality that applies this concept to the family and relates to the meaning of the family’s existence in terms of the entire family. The purpose of this study was to clarify the attributes of family spirituality and the influencing factors of its decline. Methods: Regarding family spirituality, 1) a literature search was conducted using PubMed and reviews of 20 English-language articles;and 2) semi-structured interviews were conducted with 12 Japanese families having elderly members in the household. Data triangulation was performed for both, and a directed content analysis was conducted using Hohashi’s Concentric Sphere Family Environment Theory as the framework. Results: Attributes of family spirituality included 21 categories, such as “I think that my family exists for my children and grandchildren.” Factors influencing the decline in family spirituality included 20 categories in total, including 6 categories of risk/causal/promoting factors such as “lack of caring for family members”;11 categories of preventive/inhibitory/suppression factors such as “healthcare professionals not being close to the family”;and three categories of context-sensitive factors such as “death of a family member.” Conclusions/Implications for Practice: Family intervention requires nurses to understand the attributes of family spirituality and to control the influencing factors of a decline in family spirituality. Through such efforts, families will be able to discover the meaning of the existence of the family and maintain and improve their well-being.展开更多
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.
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.”
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.
基金supported by the Basic Medical Research Foundation of Naval Medical University(2022SK029 and 2023QN035).
文摘Objectives:To assess job satisfaction among anesthesia graduates working in various medical institutions across China.Methods:A cross-sectional survey was conducted,collecting demographic information,Minnesota Satisfaction Questionnaire scores,work pressure,and turnover intentions.Multiple linear regression analysis was used to examine factors influencing job satisfaction.The electronic survey was distributed to Chinese anesthesia graduates from December 2021 to January 2022.Results:A total of 595 questionnaires were distributed,with 318 valid responses,resulting in a response rate of 53.4%.The participants’overall job satisfaction score on the Minnesota Satisfaction Questionnaire was 75.85±12.57.Multiple linear regression analysis identified the following variables as significantly associated with job satisfaction:age,daily working hours,income,current position,and work pressure.Conclusions:Anesthesia graduates in China reported slightly higher-than-average overall job satisfaction.However,several issues remain.Attention should be given to the impact of factors such as youth,long working hours,low income,current position,and high work pressure on job satisfaction.The government should support anesthesiologists with improved training,job security,and benefits to enhance job satisfaction.
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.
基金Supported by the Self-Funded Plan for Scientific and Technological Research and Development of Shijiazhuang City in 2022,No.221460383.
文摘BACKGROUND Intellectual disability(ID),affecting 1%-3%of children globally,presents significant challenges for parents that often translate into occupational stress.While studies document elevated parenting stress levels(33.57 vs 26.46 in controls),job-related impacts remain poorly understood.This study employs propensity score matching(PSM)to rigorously analyze work stress determinants among parents of preschool-aged children with ID,controlling for socioeconomic and behavioral confounders.The research bridges a critical gap by examining how workplace demands intersect with special caregiving responsibilities,aiming to identify modifiable risk factors for targeted interventions.Findings will inform evidence-based workplace accommodations and support policies,offering novel insights into the occupational consequences of parenting a child with ID through advanced causal inference methods.This work holds important implications for hazard ratio(HR)policies and social support systems serving this vulnerable population.AIM To explore the factors affecting the job stress of parents of preschool children with mental retardation(MR),based on the PSM.METHODS One hundred and twenty-five children aged 3-6 years who were treated in our hospital from December 2022 to December 2024 were included in the questionnaire survey.Five cases were excluded due to incomplete data,and 120 cases completed the study.The questionnaire was filled out by the parents of the children,and 100 parents of normal children were selected to be included in the control group.After the baseline difference was balanced by PSM 1:1 matching,the general information,scores of parental stress in each dimension and parental stress level of the two groups were compared and analyzed.Single factor analysis was carried out on the factors affecting the parental stress of group;Pearson was used to analyze the correlation between the factors affecting parental stress in MR group.Logistic regression was used to analyze the factors affecting the job stress of parents in MR group.RESULTS After matching,there were 97 cases in both groups.The differences of parents'working status and family location in MR group were statistically significant,P<0.05.Parents in MR group were significantly higher than those in control group in every dimension and total score,of which 75.22%were at a high level,P<0.05.Univariate analysis shows that the older the parents are,the more unstable their work status is,the lower their education level is,the less their family income is,their location is in the countryside and the children have a genetic history,the higher their parental stress score is.Pearson correlation analysis showed that the total score of parental stress was related to supporting friends(r=-0.354),seeking social support,maintaining self-esteem and psychological stability(r=-0.146),coping style frequency(r=-0.476)and role size(r=-0.063).P<0.05.Using the binary Logistic regression model,it was found that whether the child had a genetic history(HR=1.667)was a risk factor affecting the parents'job stress of MR children,and friends'support(HR=0.539),seeking social support(HR=0.478),maintaining self-esteem and psychological stability(HR=0.625),and the frequency and role of coping styles(HR=0.794)were all its protective factors,P<0.05.CONCLUSION Parents'parental stress of most preschool children with MR is at a high level,in which children's genetic history is its risk factor,and friends'support,seeking social support,maintaining self-esteem and psychological stability,as well as the frequency and role of coping styles are its protective factors,which provides new intervention programs and measures to alleviate parents'parental stress of MR children.
文摘BACKGROUND The development of prostate cancer(PC)frequently intensifies negative emotional states,such as anxiety and depression,which compromise the effectiveness of radical surgery and reduce treatment adherence.In this study,we hypothesized that psychological resilience plays a crucial role in this process and explored its impact.AIM To investigate the association of resilience with anxiety and depression in patients with PC and to analyze the influencing factors.METHODS We selected 147 patients with PC who visited Qingdao Traditional Chinese Medicine Hospital from January 2022 to June 2024.The resilience scores of patients with PC were assessed using the Connor-Davidson Resilience Scale(CDRISC)from the tenacity,self-improvement,and optimism dimensions.Based on the total CD-RISC score,patients were categorized into groups A(total CD-RISC score>63 points,n=69)and B(total CD-RISC score≤63 points,n=78)for comparative analysis of anxiety[Hamilton Anxiety Rating Scale(HAMA)],depression[Hamilton Depression Rating Scale(HAMD)],sexual function[International Index of Erectile Function-5(IIEF-5)and Sexual Life Quality Questionnaire-Quality of Life(SLQQ-QOL)],and quality of life[the EORTC Core Quality of Life Question naire(QLQ-C30)].The association between CD-RISC and the above indicators was analyzed with Spearman correlation coefficients,and the influencing factors of resilience in patients with PC were identified with binary logistic regression.RESULTS Group A demonstrated statistically lower HAMA and HAMD scores and markedly higher scores of IIEF-5,SLQQQOL,and various QLQ-C30 aspects.Correlation analysis revealed that CD-RISC was significantly negatively correlated with HAMA and HAMD scores and significantly positively correlated with IIEF-5,SLQQ-QOL,and QLQ-C30 total scores.Binary logistic regression analysis revealed educational and per capita monthly household income levels as significant influencing factors of resilience in patients with PC.CONCLUSION Our results indicate a significant correlation of resilience with anxiety and depression in patients with PC.The milder the anxiety and depression emotions in patients,the higher their resilience.Further,assisting patients with PC to improve their educational and per capita monthly household income levels will help their resilience to some extent.
基金National Natural Science Foundation of China,No.42171216,No.71733001Key R&D Program of Beijing Municipal Education Commission,No.KZ202210038047Tsinghua University Initiative Scientific Research Program,No.2022THZWJC15。
文摘Research on urban health constitutes an important issue in the field of health geography and also a strong propeller of the Healthy China Initiative.As the main form that realizes new-type urbanization,urban agglomerations should become the primal sites for the construction of a“Healthy China”.The evaluation of healthy cities’development in urban agglomerations has both theoretical and practical values.Based on the concept of urban health and its evaluation models,this paper developed an evaluation framework for healthy cities that involved multiple data sources.With 19 urban agglomerations in China as the research subjects,we used CRITIC weighting and geographical detectors to examine the geographies of healthy cities and their influencing factors in 2010 and 2020.The results were fourfold.Firstly,the urban health level of China significantly increased from 2010 to 2020,and the comprehensive health index developed towards a positive skewed distribution,along with a shift from“low in the hinterland-high in the coastal areas”to a“multipolar”pattern led by the coastal and southwest urban agglomerations.Secondly,among various dimensions of urban health,the healthy environment index became improved with narrowed regional differences;while the health services index was still polarized;health collaboration was upgraded with a strengthened intercity health network;the healthy population index slightly declined and converged to the middle.Thirdly,urban health in China has initially demonstrated the characteristics of a H-H pattern in the Yangtze River Delta and ChengduChongqing regions,as well as L-L clusters in the northern urban agglomerations,the narrowed regional differences,and increasing coordination within each urban agglomeration.Fourthly,the geographical detector found that economy,urbanization and the human capital were significant external factors that affected urban health development.The explanatory power of technological innovation and opening to the outside world were also increasing.The development of healthy cities is yet to be transformed into regional health integration.
文摘With the accelerated pace of population aging in China,the number of patients suffering from myocardial infarction(MI)is increasing annually.During disease progression,patients are at significantly higher risk of developing severe negative emotions,and emerging evidence suggests that post-traumatic stress disorder(PTSD)is significantly associated with cardiovascular disease,which seriously affects patients’quality of life.Objective:The aim of this study was to comprehensively assess the prevalence and influencing factors of PTSD in MI patients through systematic review and Meta-analysis.Methods:A computerized search of PubMed,the Cochrane Library,Embase,Web of Science,PsycINFO,China Knowledge Network(CNKI),WanFang Data,VIP,and China Biomedical Literature Database(CBM)was conducted to collect longitudinal studies,case-control studies,and cross-sectional studies related to PTSD prevalence rates and influencing factors in MI patients published up to August 1,2024.Literature screening,data extraction and quality assessment were done independently by two researchers and Meta-analysis was done using Stata 16.0 software.This study has been registered on the PROSPERO platform,registration number:CRD42024577243.Results:A total of 16 papers were included,with a total sample size of 3,768 cases involving 8 influencing factors.The results of the Meta-analysis showed that the prevalence of PTSD in patients with MI was 20.4%(95%CI=15.0–26.5%).Female(OR=3.12,95%CI=1.97–4.97,P<0.001),high neuroticism score(OR=2.21,95%CI=1.20–4.07,P=0.011),and high intrusive rumination score(OR=2.95,95%CI=1.50–5.83,P=0.002)were the risk factors for PTSD in MI patients.While age(OR=1.01,95%CI=0.98–1.04,P=0.440),education level(OR=0.55,95%CI=0.07–4.48,P=0.574),social support rating scale(OR=0.81,95%CI=0.52–1.26,P=0.346),Killip cardiac function classification(OR=2.29,95%CI=0.91–5.80,P=0.080)and creatine kinase isoenzyme(OR=1.03,95%CI=0.99–1.05,P=0.124)were not associated with the development of PTSD in MI patients.Conclusion:The prevalence of PTSD was higher in patients with MI.The prevalence varied by evaluation tool and study area.Risk factors were multifactorial,including general factors(female)and overall assessment(high neuroticism score,high invasive rumination score).Therefore,early intervention and proper de-escalation of PTSD symptoms in patients with MI by medical staff are needed in clinical practice to reduce the risk of PTSD.
文摘BACKGROUND Post-stroke depression(PSD),a condition commonly developed in patients with chronic stroke,impairs both functional rehabilitation and daily living.AIM To comprehensively analyze PSD contributors in chronic phase stroke and construct a precise nomogram.METHODS Two hundred patients with chronic stroke admitted in over 7 years(January 2017 to January 2024),were enrolled and categorized into the PSD group(n=96)and the non-PSD(NPSD)group(n=104).Demographic characteristics,clinicopathological data,and biochemical indicators were collected and analyzed by univariate analysis.Significant predictors identified in the univariate analysis were subsequently incorporated into a binary logistic regression model to assess their independent effects on PSD risk.The discriminative ability/calibration of the developed PSD prediction nomogram was assessed.RESULTS Compared with the NPSD group,the PSD group included a higher proportion of patients aged≥60 years,divorced/widowed,with an education level below senior high school,presenting with≥2 comorbidities,exhibiting severe neurological impairment,and having multiple lesions.Additionally,the PSD group showed significantly higher neutrophil-to-lymphocyte ratio(NLR)and platelet-tolymphocyte ratio(PLR)than the NPSD group.After assigning values to significant predictors,multivariate analysis indicated that educational level(P=0.046),NLR(P<0.001),and PLR(P<0.001)were independently associated with PSD in patients with chronic stroke.The developed nomogram exhibited favorable discrimination performance.The nomogram's calibration remained accurate for high-risk stratification but displayed modest inconsistencies in lowand middle-risk categories.CONCLUSION Education level,NLR,and PLR independently contribute to PSD in patients with chronic stroke.The constructed nomogram effectively predicts PSD risk within the range of 0.10-0.90,presenting a valuable tool for clinical monitoring and risk assessment of PSD in patients with chronic stroke.
基金supported by the Philosophy and Social Science Research Youth Project of the Hubei Department of Education in 2022(22Q148).
文摘Objectives:The study aimed to survey the current situation and explore the factors that influence the ability of palliative care practice among oncology nurses.Methods:A multicenter cross-sectional study was conducted using stratified random sampling to select 26 tertiary hospitals’oncology departments in Hubei Province,China.A total of 1,198 nurses were included and finished the questionnaire consisting of social demographic characteristics,Palliative Care Self-Report Practice Scale(PCPS),End-of-life Professional Caregiver Survey(EPCS),and Self-Perceived Pain Assessment Knowledge and Confidence Scale(Self-PAC)through the online platform.Data were analyzed using t-test,one-way ANOVA,Pearson correlation analysis,and multiple linear regression analysis in SPSS 26.0.Results:The total score for PCPS was 67.17±12.57,the three dimensions’scores were:physical symptom care(32.50±6.10),spiritual and psychological care(23.35±4.97),communication(11.58±2.48).There are significant positive correlations between the palliative care practice ability and core competence(r=0.77,P<0.01),as well as pain assessment ability(r=0.56,P<0.01).Multiple regression analysis identified female,with high education background(bachelor’s degree and master’s degree or above),interest in palliative care,pain assessment ability,and core competence were positive predictors of palliative care practice ability(Adjusted R^(2)=0.668,P<0.05).Conclusions:The overall ability of the oncology nurses to practice palliative care was relatively high,but the palliative nurses reported suboptimal performance in the communication dimension of palliative nursing practice ability.To comprehensively improve oncology nurses’palliative care practice ability,managers must consider the gender structure,educational background,enthusiasm for palliative care work,core competence,and pain assessment ability.
文摘BACKGROUND In cases of colorectal cancer(CRC)with obstruction,patients experience local tissue edema due to intestinal obstruction.This condition stimulates the accumulation of inflammatory factors,activates cancer cells,and increases the risk of tumor recurrence.At present,analyses and evaluation tools for factors influencing early postoperative recurrence in patients with CRC and obstruction are limited.AIM To explore the influencing factors and construct a predictive model of the early postoperative recurrence of CRC with obstruction.METHODS Data from 181 patients with CRC and obstruction who underwent surgery in the Department of Gastrointestinal Surgery,Suzhou Ninth Hospital Affiliated to Soochow University,between January 2017 and May 2023 were retrospectively collected.Patients with CRC and obstruction were divided into a recurrence group and a non-recurrence group based on whether recurrence occurred during the 2-year follow-up after surgery.Datasets from the two groups were compared.Subsequently,multiple logistic regression was employed to analyze the influencing factors of the early postoperative recurrence of CRC with obstruction.The nomogram prediction model was drawn using R software,and its performance was evaluated by the goodness of fit test and receiver operating characteristic(ROC)curve analysis.The clinical benefit rate of the model was evaluated by decision curves.RESULTS Among the 181 patients with CRC and obstruction,52(28.73%)experienced tumor recurrence within 2 years after surgery.Significant differences were observed in preoperative carcinoembryonic antigen(CEA),preoperative systemic immuneinflammation index(SII),tumor,node,and metastasis(TNM)stage,differentiation degree,nerve infiltration,and Ki-67 expression between the recurrence and non-recurrence groups(P<0.05).Multivariate logistic regression analysis showed that high preoperative CEA(OR=2.094,P=0.008),high preoperative SII(OR=2.795,P<0.001),TNM stage III(OR=1.644,P=0.027),poor differentiation(OR=1.861,P=0.035),and high Ki-67 expression(OR=2.467,P=0.001)were all influencing factors for early postoperative recurrence of CRC with obstruction.The area under the ROC curve of the nomograph model constructed based on this was 0.890,the goodness of fit deviation test was conducted(χ^(2)=3.903,P=0.866),and the decision curve display model demonstrated practical value in clinical practice.CONCLUSION The early recurrence rate of CRC with obstruction is high.CEA,SII,TNM staging,differentiation degree,and Ki-67 expression are factors related to early postoperative recurrence.A nomogram prediction model incorporating these factors can effectively evaluate the risk of early postoperative recurrence in patients with CRC.
基金The National Natural Science Foundation of China(No.52072012)。
文摘To investigate the distribution characteristics and influencing factors of bicycle detour behavior,this study ac-curately identified detour behavior using global positioning system(GPS)track data from shared bicycles.Factors such as travel time,road conditions,public transportation facilities,and land use types were considered in constructing a detour behavior influence model based on the CatBoost machine learning algorithm.The interpretability of the machine learning framework was enhanced via Shapley additive explanations(SHAP),enabling an analysis of the impact of each factor on detour behavior.The results indicated that the CatBoost model effectively recognized detour behavior with high accuracy.The frequency of detour behavior increased with higher road levels,greater distances to crossing facilities,wider bike lanes,and an increased number of bus stops,subway stations,and leisure and entertainment facilities,while it decreased with a higher number of office commuting facilities.In addition,detour behavior was more prevalent on weekends,during off-peak hours,and under conditions involving physical central lane separation and physical bike lane separation.These findings offer a novel approach for identifying bicycle riding behaviors and analyzing their influencing factors,providing effective technical support for non-motorized traffic management and infrastructure optimization.
基金National Natural Science Foundation of China,No.42230106,No.42171250State Key Laboratory of Earth Surface Processes and Resource Ecology,No.2022-ZD-04。
文摘Agriculture holds a pivotal position in the economic fabric of every nation,yet concerns about agricultural carbon emission intensity(ACI)have become a major hurdle to achieving global economic sustainability.Focusing on 31 provincial-level regions in China,this study uses the Exploratory Spatio-temporal Data Analysis(ESTDA)and Panel Quantile Regression(PQR)model to analyze the spatio-temporal interaction characteristics and influencing factors of ACI in China from 2004 to 2023.The findings are as follows:(1)ACI showed an overall downward trend,and the spatial distribution pattern was characterized by“high in the western region and low along the southeastern coast”.Although the overall disparity tended to converge,some high-carbon-intensity regions exhibited extreme trends.ACI displayed clear spatial directionality,with the spatial center shifting steadily toward the northeast.(2)Regions in the northwest,northeast,and central-south parts exhibited strong local spatial structural dynamics,and the local spatial dependence of ACI in each region showed a nonlinear trend.Generally speaking,the spatial association pattern demonstrated a certain degree of inertia in spatial transfer,reflecting strong path dependence or spatial lock-in characteristics.(3)Optimization of industrial structure and improvement in agricultural mechanization will increase ACI,while economic development can effectively reduce it.The impact of urbanization on ACI exhibits a nonlinear pattern.The coordinated development of economic growth and urbanization significantly reduces ACI,with a stronger emission reduction observed in regions with low ACI.The optimization of industrial structure,when combined with urbanization and environmental regulation,contributes to significant emission reductions particularly in high-ACI areas.Similarly,the synergy between agricultural mechanization and urbanization effectively lowers emissions in low-ACI regions,though this effect diminishes in areas with higher ACI.
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 The prevalence and severity of noncommunicable chronic diseases(NCDs)among Chinese residents have been increasing with mental health emerging as a critical challenge in disease management.AIM To examine the interactions between depression,anxiety symptoms,and related factors,and to identify key factors in the Chinese population with NCDs.METHODS Data from the Psychology and Behavior Investigation of Chinese Residents were used in a cross-sectional survey of 6182 individuals with NCDs.This study measured depression and anxiety symptoms as well as their influencing factorsincluding social environments,individual behaviors and lifestyles,and subjective indicators.A network analysis approach was used for data assessment.RESULTS Network analysis demonstrated that several central factors(media exposure,family health,problematic internet use,suboptimal health status,intimate relationship violence,tired or little energy,and nervousness/anxious/on edge)and bridge factors(media exposure,problematic internet use,intimate partner violence,health literacy,and suboptimal health status)that significantly influenced the co-occurrence and interconnectedness of depression and anxiety symptoms.Additionally,gender,ethnicity,residency,and living status did not significantly influence the overall network strength.CONCLUSION Depression and anxiety are prevalent among the Chinese population with NCDs.Effective interventions should focus on managing key symptoms,promoting correct media use for health information,and fostering healthier family relationships.
文摘BACKGROUND Colorectal cancer(CRC)is a common malignant tumor in the digestive system,whose main treatment comprises surgical resection,radiotherapy and chemotherapy,and targeted drug therapy.At present,the radical resection of CRC is the main way of achieving an early cure.AIM To investigate the logistic regression analysis of bone metastasis after CRC surgery and related influencing factors.METHODS We selected 100 patients who underwent surgery for CRC and were admitted from February 2018 to February 2024,collected the general data of bone metastasis,and collected the pathological characteristics of patients with bone metastasis.Next,we divided them into groups with and without bone metastasis(Bone metastases group,n=44;no bone metastases group,n=56),compared the clinical data of the two groups,and analyzed the risk factors of bone metastasis using logistic regression analysis.RESULTS Among the 100 patients,the mean age was 54.33±8.45 years,and most were male(54.55%).The proportion of patients with lytic bone changes was 43.18%.The most common location of combined bone metastasis was the pelvis,whereas only 5 patients had limb transfer.There was a higher incidence of lung than of pancreatic or liver metastases.Regression analysis showed that the primary location of the cancer was rectal cancer.Lymph node involvement,lung metastasis,and no postoperative chemotherapy were the risk factors for postoperative bone metastasis in patients who underwent surgery for CRC(P<0.05).CONCLUSION Rectal cancer,lymph node involvement,complicated pulmonary metastasis,and no postoperative chemotherapy treatment can help predict high risk of bone metastasis in CRC.
基金supported by the Key Laboratory of Natural Resources Monitoring and Supervision in Southern Hilly Region,Ministry of Natural Resources(NRMSSHR2023Y02)Yunnan Key Laboratory of Plateau Geographic Processes and Environmental Changes,Faculty of Geography,Yunnan Normal University(PGPEC2304)China Scholarship Council。
文摘Sloping farmland,particularly in mountainous and hilly areas,constitutes a significant component of regional farmland resources.An investigation into the spatio-temporal pattern of sloping farmland and its influencing factors in China is imperative for the efficient utilization of farmland and the optimization of land space.We used land use transfer matrix,geographically weighted regression model and geographical detector to conduct this study.Results showed that sloping farmland in China firstly decreased and then increased from 2000 to 2020.The proportion of sloping farmland decreased radially outward from Sichuan basin to the surrounding areas.Change rates of sloping farmland with different slopes varied and the slope with 6°-15°underwent the fastest changes.The influencing factors of farmland at various slope degrees were different.For sloping farmland below 15°,land use intensity and elevation had the greatest contribution.For sloping farmland between 15°and 25°,elevation,land use intensity,and population density were the main influencing factors.Sloping farmland above 25°was mostly affected by natural factors.This study can provide scientific basis for rational development and protection of sloping farmland.
文摘Background and Purpose: In recent years, individual spirituality has been attracting attention, but little research has been conducted as it relates to family spirituality that applies this concept to the family and relates to the meaning of the family’s existence in terms of the entire family. The purpose of this study was to clarify the attributes of family spirituality and the influencing factors of its decline. Methods: Regarding family spirituality, 1) a literature search was conducted using PubMed and reviews of 20 English-language articles;and 2) semi-structured interviews were conducted with 12 Japanese families having elderly members in the household. Data triangulation was performed for both, and a directed content analysis was conducted using Hohashi’s Concentric Sphere Family Environment Theory as the framework. Results: Attributes of family spirituality included 21 categories, such as “I think that my family exists for my children and grandchildren.” Factors influencing the decline in family spirituality included 20 categories in total, including 6 categories of risk/causal/promoting factors such as “lack of caring for family members”;11 categories of preventive/inhibitory/suppression factors such as “healthcare professionals not being close to the family”;and three categories of context-sensitive factors such as “death of a family member.” Conclusions/Implications for Practice: Family intervention requires nurses to understand the attributes of family spirituality and to control the influencing factors of a decline in family spirituality. Through such efforts, families will be able to discover the meaning of the existence of the family and maintain and improve their well-being.
