BackgroundIt's crucial to study the effect of changes in thresholds(T)and most comfortable levels(M)on behavioral measurements in young children using cochlear implants.This would help the clinician with the optim...BackgroundIt's crucial to study the effect of changes in thresholds(T)and most comfortable levels(M)on behavioral measurements in young children using cochlear implants.This would help the clinician with the optimization and validation of programming parameters.ObjectiveThe study has attempted to describe the changes in behavioral responses with modification of T and M levels.MethodsTwenty-five participants in the age range 5 to 12 years using HR90K/HiFocus1J or HR90KAdvantage/HiFocus1J with Harmony speech processors participated in the study.A decrease in T levels,a rise in T levels,or a decrease in M levels in the everyday program were used to create experimental programs.Sound field thresholds and speech perception were measured at 50 dBHL for three experimental and everyday programs.ConclusionThe results indicated that only reductions of M levels resulted in significantly(p<0.01)poor aided thresholds and speech perception.On the other hand,variation in T levels did not have significant changes in either sound field thresholds or speech perception.The results highlight that M levels must be correctly established in order to prevent decreased speech perception and audibility.展开更多
Objective:To explore the associations between income levels,employment risk,lifestyles,occupational stress,and male fertility.Methods:This cross-sectional study analyzed 294 men seeking fertility treatment at fertilit...Objective:To explore the associations between income levels,employment risk,lifestyles,occupational stress,and male fertility.Methods:This cross-sectional study analyzed 294 men seeking fertility treatment at fertility clinics in Terengganu,Pahang,and Kuala Lumpur from November 2021 to June 2023.Data were collected through structured questionnaires covering income levels,lifestyles,employment risks,occupational stress,and semen quality.Multinomial logistic regression was employed to assess predictors of semen quality,with crude and adjusted odds ratios(OR)reported.Results:The lower-income group exhibited higher odds of having abnormal semen quality compared to normal semen quality.Specifically,these participants were more likely to experience azoospermia[crude OR 6.68,95%confidence interval(CI)1.84-52.63;adjusted OR 6.26,95%CI 1.76-51.38],indicating a link between low income and infertility issues.Lifestyle factors did not show significant associations with semen abnormalities after adjustment.High employment risks had significant associations with oligozoospermia after adjustment(crude OR 5.50,95%CI 2.14-14.11;adjusted OR 5.15,95%CI 1.93-13.71),while high occupational stress was linked to asthenozoospermia(crude OR 2.26,95%CI 1.09-4.68;adjusted OR 2.25,95%CI 1.07-4.69).Conclusions:The findings underscore the influence of socioeconomic and occupational factors on male fertility,showing associations between lower income levels,high-risk occupations,and semen abnormalities.In contrast,lifestyle factors did not show significant associations with semen abnormalities after adjustment.Nevertheless,the current findings should be further confirmed through more extensive studies focusing on abnormal semen and lifestyle factors.展开更多
The increasing dependence on fossil fuels and the consequent CO_(2)emissions have prompted urgent energy and environmental challenges[1,2].Solar-driven CO_(2)conversion into value-added fuels offers a sustainable and ...The increasing dependence on fossil fuels and the consequent CO_(2)emissions have prompted urgent energy and environmental challenges[1,2].Solar-driven CO_(2)conversion into value-added fuels offers a sustainable and promising solution to these issues[3].However,the practical implementation of CO_(2)photoreduction is constrained by low efficiency,primarily due to the rapid recombination of photogenerated electron-hole pairs[4].展开更多
BACKGROUND Cold-inducible RNA-binding protein(CIRP)is related to a family of stressinduced RNA-binding proteins.It is primarily found in the nucleus,where it regulates transcription.Under stress,CIRP translocates to t...BACKGROUND Cold-inducible RNA-binding protein(CIRP)is related to a family of stressinduced RNA-binding proteins.It is primarily found in the nucleus,where it regulates transcription.Under stress,CIRP translocates to the cytoplasm where it modulates translation;a subset is secreted as extracellular CIRP(eCIRP)which is a damage-associated molecular pattern(DAMP)molecule that stimulates the production of inflammatory mediators.Elevated blood eCIRP levels may foster immune tolerance and facilitate tumor growth.Increased CIRP levels have been noted in various malignancies including colorectal cancer(CRC).This study’s objective was to determine plasma eCIRP levels before and after minimally invasive colorectal resection(MICR)for CRC.AIM To assess plasma eCIRP levels prior to and following minimally invasive colorectal resection in the context of cancer pathology.METHODS MICR patients from an IRB-approved data/tissue bank for whom plasma samples were available were eligible.Plasma specimens were obtained preoperatively(preop)and at least 3 time’s postop[between postoperative day(POD)1-41];late samples were grouped into 7-day blocks and were considered separate time points.eCIRP levels were assessed via enzyme-linked immunosorbent assay(pg/mL)and results presented as mean±SD,analysis with Wilcoxon paired t-test.RESULTS A total of 83 CRC patients who underwent MICR[colon 66%,rectal 34%;laparoscopic-assisted(LA),70%;handassisted laparoscopic(HAL),30%]were studied.The mean preop eCIRP level was 896.8±757.0 pg/mL.Elevations in mean plasma levels(P=<0.001)were noted on POD1(2549±2632 pg/mL,n=83),POD3(1871±1362 pg/mL,n=77),POD7-13(1788±1403 pg/mL,n=57),POD14-20(1473±738.8 pg/mL,n=30),and POD21-27(1681±1375 pg/mL,n=21).No significant differences were noted at POD 28-41.Higher values were noted in the HAL’s(vs LA)group,however,there were more rectal cancers in the former.CONCLUSION Elevated plasma eCIRP levels persist for a month post MICR for CRC(change from baseline,77%-184%);highest values seen on POD1.The initial surge may be due to the acute inflammatory response while later elevations may be related to wound healing and remodeling.The higher levels noted in the HAL’s group(with greater IL and more rectal cases)suggest the extent of surgical trauma impacts eCIRP levels.Further investigations are needed.展开更多
Computed tomography is an indispensable X-ray imaging modality used to diagnose numerous pathologies, but it can also involve the delivery of high ionizing radiation doses harmful to the health of patients. This study...Computed tomography is an indispensable X-ray imaging modality used to diagnose numerous pathologies, but it can also involve the delivery of high ionizing radiation doses harmful to the health of patients. This study aims to survey the level of radiation doses delivered to child patients during head exams in CT imaging to set up the Dosimetric Reference Levels (DRLs), a routine dose optimization tool, based on data acquired at the University Hospital of Angré (UHA), the University Hospital of Treichville (UHT) and the Polyclinic Hospital Farah (Farah) for optimizing procedures in Ivorian hospitals. Prospectively performed on 334 CT images of 186 child patients, this study was carried out on CT systems such as Hitachi Scenaria, Sinovision Insitum, and Philips Incisive used respectively at UHA, UHT and Farah. Children’s scan data were classified into four age bands: vol or dose-length product as DLP) value, whatever the hospital, increases with respect to the age of child patients. Based on the 75th percentile of the whole dose distributions, the DRLs of the CTDIvol is 54.37 mGy whatever the age groups and those of the DLP with respect to age bands are 1224.55 mGy∙cm, 1414.06 mGy∙cm, 1632.24 mGy.cm and 1544.57 mGy∙cm, respectively. The averaged values of CTDIvol and DLP smaller than the corresponding DRLs values suggest that practices in our three facilities are optimized. However, comparing our results with those from different international studies, we see that the CTDIvol and DLP values obtained in the present work are higher. These results suggest additional surveys to ensure our DRLs values and efforts from radiologists, imaging technicians and medical physicists to strengthen clinical procedures for the radiation protection of children undergoing CT scans in Côte d’Ivoire.展开更多
This study focuses on the elderly population in Xueyuan Road Street of Haidian District in Beijing.Through KANO questionnaires and the theory of attractive quality,it investigates the demand levels and degrees for dif...This study focuses on the elderly population in Xueyuan Road Street of Haidian District in Beijing.Through KANO questionnaires and the theory of attractive quality,it investigates the demand levels and degrees for different community elderly care services.It introduces the Anderson behavioral model to analyze the influencing factors,categorizes different demographics,and examines the needs of elderly individuals with varying characteristics,proposing suggestions for the improvement of future community elderly care service facilities.展开更多
BACKGROUND Diabetic kidney disease(DKD)has become the leading cause of end-stage renal disease.The disease characteristics,morbidity,and renal function progression rate of patients with DKD are all related to sex.This...BACKGROUND Diabetic kidney disease(DKD)has become the leading cause of end-stage renal disease.The disease characteristics,morbidity,and renal function progression rate of patients with DKD are all related to sex.This suggests that sex hormones may play an important role in changing renal function in patients with diabetes.There have been only a few studies on the correlation between sex hormones and DKD,which have contradictory conclusions.AIM To investigate the relationship between circulating sex hormone levels and DKD in men and postmenopausal women with type 2 diabetes mellitus(T2DM).METHODS This retrospective cross-sectional study included 356 patients with T2DM.Pearson or Spearman rank correlation analyses assessed the relationships between sex hormone levels and renal function indices.By adjusting for age,body mass index,systolic blood pressure,diastolic blood pressure,duration of diabetes,use of sodium-glucose cotrasporter-2 inhibitor,use of glucagon-like peptide-1 receptor agonist,hypertension,use of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker/angiotensin receptor-neprilysin inhibitor,diabetic retinopathy,diabetic peripheral vascular disease,triglyceride,uric acid,and hemoglobin A1c,multiple linear regression and logistic regression analyses were conducted to identify factors influencing the urinary albumin/creatinine ratio(UACR)and DKD.RESULTS In men,dehydroepiandrosterone sulfate levels were inversely associated with log-transformed UACR after adjustment for covariate factors[regression coefficient(β)=-0.691,95%confidence interval(CI):-1.241 to-0.141 for quartile 4 vs quartile 1;P=0.006 for trend].Elevated levels of estradiol were positively associated with DKD[odds ratio(OR)=3.097,95%CI:1.083-8.856 for quartile 4 vs quartile 1;P=0.041 for trend],and higher luteinizing hormone(LH)levels were similarly associated with DKD(OR=4.164,95%CI:1.30-13.330 for quartile 4 vs quartile 1;P=0.048 for trend).In postmenopausal women,LH levels were positively correlated with log-transformed UACR and DKD(β=1.039,95%CI:0.284-1.794 for quartile 4 vs quartile 1;P=0.006 for trend and OR=15.117,95%CI:2.191-104.326 for quartile 4 vs quartile 1;P=0.004 for trend).Follicle-stimulating hormone(FSH)levels were also positively associated with DKD(OR=9.588,95%CI:1.680-54.709 for quartile 4 vs quartile 1;P=0.014 for trend).CONCLUSION In men with T2DM,elevated levels of estradiol and LH levels were positively associated with increased risk of DKD.In postmenopausal women with T2DM,high FSH and LH levels were positively associated with increased risk of DKD.展开更多
The purpose of this research was to evaluate radiological safety in pediatric radiology in hospitals in the Kongo Central province of the DRC. To this end, we surveyed a convenience sample of 50 health professionals, ...The purpose of this research was to evaluate radiological safety in pediatric radiology in hospitals in the Kongo Central province of the DRC. To this end, we surveyed a convenience sample of 50 health professionals, including 10 radiologists working in the hospitals covered by the survey, to assess the practice of pediatric radiology and the degree of compliance with radiation protection principles for the safety of children and the environment. We collected radiophysical parameters to calculate entrance doses in pediatric radiology in radiology departments to determine the dosimetric level by comparison with the diagnostic reference levels of the International Commission on Radiological Protection (ICRP). All in all, we found that in Kongo Central in the DRC, many health personnel surveyed reported that more than 30% of requested radiological examinations are not justified. Also, after comparing the entrance doses produced in the surveyed departments with those of the International Commission on Radiological Protection (ICRP), a statistically significant difference was found in pediatric radiology between the average doses in five out of six surveyed departments and those of the ICRP. Therefore, almost all of the surveyed departments were found to be highly irradiating in children, while excessive X-ray irradiation in children can have significant effects due to their increased sensitivity to radiation. Among the risks are: increased cancer risks, damage to developing cells, potential genetic effects, and neurological effects. This is why support for implementing radiation protection principles is a necessity to promote the safety of patients and the environment against the harmful effects of X-rays in conventional radiology.展开更多
Metallogenic research on structural levels can reveal vertical patterns of mineralization and facilitate the deep exploration of economic minerals.However,research focusing on the correlation between structural levels...Metallogenic research on structural levels can reveal vertical patterns of mineralization and facilitate the deep exploration of economic minerals.However,research focusing on the correlation between structural levels and mineralization remains limited.In this study,we summarize the deformation patterns and associated mineral deposits observed at different crustal levels(i.e.,surface,shallow,middle,and deep structural levels,corresponding to depths of<2,2-8,8-15,and>15 km,respectively).Furthermore,we examine the genetic association between structural levels and metallogenesis,demonstrating that distinct structural levels are linked to specific types of mineralization.Key factors that vary across crustal levels include temperature,pressure,and fluid circulation.Ore-forming processes involve interactions between structures and fluids under varying temperatures and pressures.Structural levels influence mineralization by controlling the temperatures,pressures,and deformation mechanisms that drive the activation,migration,and enrichment of ore-forming materials.展开更多
Objective:Correlation of serum 25-hydroxyvitamin D level with senile hypertension and its stroke.Methods:Two hundred hypertensive patients admitted to the hospital from February 2022 to December 2023 were classified a...Objective:Correlation of serum 25-hydroxyvitamin D level with senile hypertension and its stroke.Methods:Two hundred hypertensive patients admitted to the hospital from February 2022 to December 2023 were classified as study subjects.They were divided into grade 2 hypertension group and grade 3 hypertension group,and 100 healthy medical checkups admitted during the same period were analyzed as study subjects.Results:Comparison of diagnostic results between grade 2 hypertension and grade 2 hypertensive stroke patients,there was a difference in 25(OH)D,(P<0.05).Comparison of test results between grade 3 hypertension and grade 3 hypertensive stroke patients,there was a difference in age,BMI,25(OH)D,GLU,LDL-C,(P<0.05).Serum 25-hydroxyvitamin D level is a high-risk factor for the occurrence of stroke in elderly hypertensive patients,so the probability of risk is higher,where 25(OH)D(ng/mL),GLU(mmol/L),there is a difference,(P<0.05).Conclusion:There is a greater relationship between the occurrence of stroke and serum 25-hydroxyvitamin D level in elderly hypertensive patients.The occurrence of the disease has a greater relationship with this indicator in patients and is also a high-risk factor that affects the patients’morbidity,so it is necessary to pay attention to the monitoring of this indicator after the onset of the disease in patients.展开更多
This study examines the impact of digital literacy on the levels of depressive symptoms of older adults,utilizing data from the 2022 China Family Panel Studies(CFPS).Factor analysis was used to construct digital liter...This study examines the impact of digital literacy on the levels of depressive symptoms of older adults,utilizing data from the 2022 China Family Panel Studies(CFPS).Factor analysis was used to construct digital literacy indicators,and OLS multiple linear regression modeling was carried out;the results demonstrate that digital literacy exerts a significant negative influence on depressive symptoms in older adults(β=-0.5385,p<0.01),and the findings are robust.Mechanism analysis reveals that digital literacy reduces depressive symptoms by enhancing future confidence(the mediation effect accounts for 18.0%).Heterogeneity analysis also indicates that there are more pronounced depressive symptoms-alleviating effects among male,married,and younger-old adults(aged 60-79)(p<0.01).Policy recommendations include implementing tiered digital literacy education programs with targeted support for vulnerable groups,enriching digital education resources through dedicated digital service platforms for the elderly,and strengthening psychological interventions to boost future confidence for effective depressive symptoms mitigation.展开更多
Fish scaleδ^(15)N(δ^(15)N_(sca))records trophic information of the whole life history for marine fishes.Data from gut content and values calculated from white muscle tissue(WMT)are insufficient for assessing trophic...Fish scaleδ^(15)N(δ^(15)N_(sca))records trophic information of the whole life history for marine fishes.Data from gut content and values calculated from white muscle tissue(WMT)are insufficient for assessing trophic level(TL)of marine fishes as they only provide the information of several months or even several days.Stable isotope analysis(SIA)of nitrogen was carried out in fish scales and WMT of 16 species from a total of 28 individuals captured from the Yellow Sea and northern East China Sea in October and November of 2019,aiming at discovering the correlation betweenδ^(15)N_(sca) and fish WMTδ^(15)N(δ^(15)NWMT),so as to useδ^(15)N_(sca) for the characterization of TLs of marine fish.Scales were analyzed without prior carbonate dissolution as a pre-processing step.TL calculated fromδ^(15)N_(sca) was compared to traditional TL formula calculated withδ^(15)N_(WMT) to estimate the accuracy.We found that there was a highly significant and positive correlation(r=0.830,P<0.001)betweenδ^(15)N_(sca) andδ^(15)N_(WMT).TL calculation results using fish scale(TL_(sca))and WMT(TL_(WMT))showed congruence(r=0.773,P<0.001),and the regression coefficient betweenδ^(15)N_(sca) andδ^(15)NWMT was used for calculating TLsca.The conversion was conducted for the purpose of comparison with previousδ^(15)N_(WMT)-based calculation results of TL.TLsca calculation results were 81.25%within the TL range of±10%calculated withδ^(15)NWMT.The findings in the present study showed thatδ^(15)N_(sca) is a viable technique for the characterization of the TL of marine fish and can help to predict food web and support the study of marine ecosystem.展开更多
Agromyzid leafminers cause significant economic losses in both vegetable and horticultural crops,and precise assessments of pesticide needs must be based on the extent of leaf damage.Traditionally,surveyors estimate t...Agromyzid leafminers cause significant economic losses in both vegetable and horticultural crops,and precise assessments of pesticide needs must be based on the extent of leaf damage.Traditionally,surveyors estimate the damage by visually comparing the proportion of damaged to intact leaf area,a method that lacks objectivity,precision,and reliable data traceability.To address these issues,an advanced survey system that combines augmented reality(AR)glasses with a camera and an artificial intelligence(AI)algorithm was developed in this study to objectively and accurately assess leafminer damage in the feld.By wearing AR glasses equipped with a voice-controlled camera,surveyors can easily flatten damaged leaves by hand and capture images for analysis.This method can provide a precise and reliable diagnosis of leafminer damage levels,which in turn supports the implementation of scientifically grounded and targeted pest management strategies.To calculate the leafminer damage level,the DeepLab-Leafminer model was proposed to precisely segment the leafminer-damaged regions and the intact leaf region.The integration of an edge-aware module and a Canny loss function into the DeepLabv3+model enhanced the DeepLab-Leafminer model's capability to accurately segment the edges of leafminer-damaged regions,which often exhibit irregular shapes.Compared with state-of-the-art segmentation models,the DeepLabLeafminer model achieved superior segmentation performance with an Intersection over Union(IoU)of 81.23%and an F1score of 87.92%on leafminer-damaged leaves.The test results revealed a 92.38%diagnosis accuracy of leafminer damage levels based on the DeepLab-Leafminer model.A mobile application and a web platform were developed to assist surveyors in displaying the diagnostic results of leafminer damage levels.This system provides surveyors with an advanced,user-friendly,and accurate tool for assessing agromyzid leafminer damage in agricultural felds using wearable AR glasses and an AI model.This method can also be utilized to automatically diagnose pest and disease damage levels in other crops based on leaf images.展开更多
Triphenylamine(TPA)is the most promising donor fragment for the construction of long-wavelength thermally activated delayed fluorescence(TADF)emitters owing to its suitable dihedral angle that could enhance radiative ...Triphenylamine(TPA)is the most promising donor fragment for the construction of long-wavelength thermally activated delayed fluorescence(TADF)emitters owing to its suitable dihedral angle that could enhance radiative decay to compete with the serious non-radiative decay.However,the moderate electron-donating capacity of TPA seriously limits the selection of acceptor for constructing longwavelength TADF emitters with narrow bandgaps.To address this issue,in this work,the peripheral benzene of TPA was replaced with 1,4-benzodioxane and anisole to obtain two new electrondonating units N-(2,3-dihydrobenzo[b][1,4]dioxin-6-yl)-N-phenyl-2,3-dihydrobenzo[b][1,4]dioxin-6-amine(TPADBO,−5.02 eV)and 4-methoxy-N-(4-methoxyphenyl)-N-phenylaniline(TPAMO,−5.00 eV),which possess much shallower highest occupied molecule orbital(HOMO)energy levels than the prototype TPA(−5.33 eV).Based on TPA and the modified TPA donor fragments,three TADF emitters were designed and synthesized,namely Py-TPA,Py-TPADBO and Py-TPAMO,with the same acceptor fragment 12-(2,6-diisopropylphenyl)pyrido[2′,3′:5,6]pyrazino[2,3-f][1,10]phenanthroline(Py).Among them,Py-TPAMO exhibits the highest photoluminescence quantum yield of 78.4%and the smallest singlet-triplet energy gap,which is because the introduction of anisole does not cause significant molecule deformation for the excited Py-TPAMO.And Py-TPAMO-based OLEDs successfully realize a maximum external quantum efficiency of 25.5%with the emission peak at 605 nm.This work provides a series of candidate of donor fragments for the development of efficient long-wavelength TADF emitters.展开更多
BACKGROUND The central link between septic shock and acute skin failure(ASF)is the inflammatory response,which occurs throughout disease progression and can lead to systemic inflammatory response syndrome.Patients oft...BACKGROUND The central link between septic shock and acute skin failure(ASF)is the inflammatory response,which occurs throughout disease progression and can lead to systemic inflammatory response syndrome.Patients often experience bad moods,sleep disorders,and other health issues.Despite recognizing these factors,no studies have examined the correlation between inflammatory factors,lactic acid levels,ASF,mood disturbances,and sleep quality in critically ill patients.We hypothesize that higher levels of inflammatory factors and lactic acid are associated with more severe ASF and poorer mood and sleep quality,which may inform clinical treatment for septic shock and ASF.AIM To explore the relationship between inflammatory factors,lactic acid levels,the severity of ASF,bad mood,and sleep quality.METHODS The retrospective study included 150 patients with septic shock from the Second Hospital of Dalian Medical University,categorized into ASF(n=35)or non-ASF groups(n=115).We compared the peripheral blood inflammatory factors,including tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6),lactic acid levels,skin mottling score(SMS),modified early warning score(MEWS),self-rating depression scale(SDS),self-rating anxiety scale(SAS),and Pittsburgh sleep quality index(PSQI)scores.Pearson correlation analysis assessed relationships among these variables.RESULTS The ASF group had significantly higher levels of CRP(19.60±4.10 vs 15.30±2.96 mg/mL),IL-6(298.65±48.65 vs 268.66±33.66 pg/L),procalcitonin,lactic acid(8.42±2.32 vs 5.70±1.27 mmol/L),SMS[0(0,1)vs 3(2,3)],MEWS(9.34±1.92 vs 6.48±1.96),SAS(61.63±12.03 vs 53.71±12.48),SDS(60.17±12.64 vs 52.27±12.64),and PSQI scores(14.23±3.94 vs 8.69±2.46)compared with the non-ASF group(all P<0.001).Pearson correlation analysis revealed that IL-6,CRP,TNF-α,and lactic acid were positively correlated with SMS,MEWS,SAS,SDS,and PSQI scores(P<0.05).CONCLUSION Peripheral blood levels of IL-6,CRP,TNF-α,and lactic acid correlate positively with SMS,MEWS,SAS,SDS,and PSQI in critically ill patients with ASF.展开更多
Objective:To explore the practical effectiveness of nursing intervention based on the theory of Gratitude Extension-Construction in improving the sense of hope in breast cancer patients.Methods:A total of 104 breast c...Objective:To explore the practical effectiveness of nursing intervention based on the theory of Gratitude Extension-Construction in improving the sense of hope in breast cancer patients.Methods:A total of 104 breast cancer patients treated in our hospital from January 2023 to May 2024 were included and divided into a control group(routine nursing,52 cases)and an observation group(routine nursing+nursing based on the theory of Gratitude Extension-Construction)using a random number table method.The Benefit Finding Scale(BFS),Hope Level Scale(HHI),and Quality of Life Questionnaire-Core 30(QLQ-C30)were used to compare and analyze the scores of the two groups before intervention,3 months after intervention,and 6 months after intervention.Results:There was no statistically significant difference in BFS,HHI,and QLQ-C30 scores between the two groups before intervention(P>0.05).Both BFS and HHI scores increased in the two groups at 3 and 6 months after intervention compared to before intervention(P<0.05),and the observation group had better BFS and HHI scores compared to the control group(P<0.05).Before intervention,there was no significant difference in QLQ-C30 scores between the two groups in all dimensions(P>0.05).Data comparison at 6 months after intervention showed that the observation group had better scores in all dimensions of QLQ-C30 than the control group(P<0.05).Conclusion:Nursing intervention based on the theory of Gratitude Extension-Construction can effectively improve the benefit-finding ability of postoperative breast cancer patients,enhance their level of hope,and improve their quality of life.It is worthy of promotion and application in clinical nursing.展开更多
BACKGROUND Chronic liver disease is a growing global health problem,leading to hepatic decompensation characterized by an array of clinical and biochemical complic-ations.Several scoring systems have been introduced i...BACKGROUND Chronic liver disease is a growing global health problem,leading to hepatic decompensation characterized by an array of clinical and biochemical complic-ations.Several scoring systems have been introduced in assessing the severity of hepatic decompensation with the most frequent ones are Child-Pugh score,model of end-stage liver disease(MELD)score,and MELD-Na score.Anemia is frequently observed in cirrhotic patients and is linked to worsened clinical outcomes.Although studies have explored anemia in liver disease,few have investigated the correlation of hemoglobin level with the severity of hepatic decompensation.AIM To determine the relationship between hemoglobin levels and the severity of decompensated liver disease and comparing the strength of this correlation using the Child-Pugh,MELD,and MELD-Na scores.METHODS This cross-sectional study was conducted at a tertiary care hospital with 652 decompensated liver disease patients enrolled in the study.Data was collected on demographics,clinical history,and laboratory findings,including hemoglobin levels,bilirubin,albumin,prothrombin time(international normalized ratio),sodium,and creatinine.The Child-Pugh,MELD,and MELD-Na scores were calculated.Statistical analysis was performed using Statistical Package for the Social Sciences version 26,and correlations between hemoglobin levels and severity scores were assessed using Spearman's correlation coefficient.RESULTS The study included 405 males(62.1%)and 247 females(37.9%)with an average age of 58.8 years.Significant inverse correlations were found between hemoglobin levels and Child-Pugh,MELD,and MELD-Na scores(P<0.01),with the MELD scoring system being the strongest correlator among all.One-way analysis of variance revealed significant differences in hemoglobin levels across the severity groups of each scoring system(P=0.001).Tukey's post hoc analysis confirmed significant internal differences among each severity group.CONCLUSION Understanding the correlation between hemoglobin and liver disease severity can improve patient management by offering insights into prognosis and guiding treatment decisions.展开更多
While the interaction between information and disease in static networks has been extensively investigated,many studies have ignored the characteristics of network evolution.In this study,we construct a new two-layer ...While the interaction between information and disease in static networks has been extensively investigated,many studies have ignored the characteristics of network evolution.In this study,we construct a new two-layer coupling model to explore the interactions between information and disease.The upper layer describes the diffusion of disease-related information,and the lower layer represents the disease transmission.We then use power-law distributions to examine the influence of asymmetric activity levels on dynamic propagation,revealing a mapping relationship characterizing the interconnected propagation of information and diseases among partial nodes within the network.Subsequently,we derive the disease outbreak threshold by using the microscopic Markov-chain approach(MMCA).Finally,we perform extensive Monte Carlo(MC)numerical simulations to verify the accuracy of our theoretical results.Our findings indicate that the activity levels of individuals in the disease transmission layer have a more significant influence on disease transmission compared with the individual activity levels in the information diffusion layer.Moreover,reducing the damping factor can delay disease outbreaks and suppress disease transmission,while improving individual quarantine measures can contribute positively to disease control.This study provides valuable insights into policymakers for developing outbreak prevention and control strategies.展开更多
Objectives:This study aimed to survey the geriatric nursing competencies of clinical nursing staff in Chongqing City,China,and provide suggestions to enhance these competencies.Methods:This study was conducted in 204 ...Objectives:This study aimed to survey the geriatric nursing competencies of clinical nursing staff in Chongqing City,China,and provide suggestions to enhance these competencies.Methods:This study was conducted in 204 hospitals in Southwest China from December 24,2022 to January 7,2023.The“Geriatric Nursing Competence of Clinical Nurse Investigation Tool”was used to explore factors that influence geriatric nurses’competencies via stratified sampling.The survey was conducted by distributing and collecting questionnaires through the online platform Wenjuanxing.Results:A total of 10,692 nurses answered the questionnaires.Of these questionnaires,9,442 were valid.The total geriatric nursing competence score of the clinical nursing staff was 2.29±0.81,the secondary hospital score was 2.23±0.78,and the tertiary hospital’s overall mean score was 2.33±0.83.The factors that influenced secondary hospitals included the department of medicine,age of nurses and total length of career(P<0.05).The factors that influenced tertiary hospitals included the department of medicine,age of nurses,nurses’professional title,and geriatric practical advanced nurses’certification(P<0.05).Conclusions:Geriatric nursing competence among clinical nursing staff is imbalanced at a lower-middle level and is influenced by various factors.Thefindings highlight the need for further clinical training in geriatric nursing.The training of geriatric nurses should focus on necessary clinical skills and on preparing them to adequately manage comprehensive geriatric syndromes.展开更多
A research study collected intensive longitudinal data from cancer patients on a daily basis as well as non-intensive longitudinal survey data on a monthly basis. Although the daily data need separate analysis, those ...A research study collected intensive longitudinal data from cancer patients on a daily basis as well as non-intensive longitudinal survey data on a monthly basis. Although the daily data need separate analysis, those data can also be utilized to generate predictors of monthly outcomes. Alternatives for generating daily data predictors of monthly outcomes are addressed in this work. Analyses are reported of depression measured by the Patient Health Questionnaire 8 as the monthly survey outcome. Daily measures include numbers of opioid medications taken, numbers of pain flares, least pain levels, and worst pain levels. Predictors are averages of recent non-missing values for each daily measure recorded on or prior to survey dates for depression values. Weights for recent non-missing values are based on days between measurement of a recent value and a survey date. Five alternative averages are considered: averages with unit weights, averages with reciprocal weights, weighted averages with reciprocal weights, averages with exponential weights, and weighted averages with exponential weights. Adaptive regression methods based on likelihood cross-validation (LCV) scores are used to generate fractional polynomial models for possible nonlinear dependence of depression on each average. For all four daily measures, the best LCV score over averages of all types is generated using the average of recent non-missing values with reciprocal weights. Generated models are nonlinear and monotonic. Results indicate that an appropriate choice would be to assume three recent non-missing values and use the average with reciprocal weights of the first three recent non-missing values.展开更多
文摘BackgroundIt's crucial to study the effect of changes in thresholds(T)and most comfortable levels(M)on behavioral measurements in young children using cochlear implants.This would help the clinician with the optimization and validation of programming parameters.ObjectiveThe study has attempted to describe the changes in behavioral responses with modification of T and M levels.MethodsTwenty-five participants in the age range 5 to 12 years using HR90K/HiFocus1J or HR90KAdvantage/HiFocus1J with Harmony speech processors participated in the study.A decrease in T levels,a rise in T levels,or a decrease in M levels in the everyday program were used to create experimental programs.Sound field thresholds and speech perception were measured at 50 dBHL for three experimental and everyday programs.ConclusionThe results indicated that only reductions of M levels resulted in significantly(p<0.01)poor aided thresholds and speech perception.On the other hand,variation in T levels did not have significant changes in either sound field thresholds or speech perception.The results highlight that M levels must be correctly established in order to prevent decreased speech perception and audibility.
基金supported by Malaysia's Ministry of Higher Education through the Fundamental Research Grant Scheme(FRGS)under the reference code FRGS/1/2020/SS0/UMT/02/3 and vote number 59637.
文摘Objective:To explore the associations between income levels,employment risk,lifestyles,occupational stress,and male fertility.Methods:This cross-sectional study analyzed 294 men seeking fertility treatment at fertility clinics in Terengganu,Pahang,and Kuala Lumpur from November 2021 to June 2023.Data were collected through structured questionnaires covering income levels,lifestyles,employment risks,occupational stress,and semen quality.Multinomial logistic regression was employed to assess predictors of semen quality,with crude and adjusted odds ratios(OR)reported.Results:The lower-income group exhibited higher odds of having abnormal semen quality compared to normal semen quality.Specifically,these participants were more likely to experience azoospermia[crude OR 6.68,95%confidence interval(CI)1.84-52.63;adjusted OR 6.26,95%CI 1.76-51.38],indicating a link between low income and infertility issues.Lifestyle factors did not show significant associations with semen abnormalities after adjustment.High employment risks had significant associations with oligozoospermia after adjustment(crude OR 5.50,95%CI 2.14-14.11;adjusted OR 5.15,95%CI 1.93-13.71),while high occupational stress was linked to asthenozoospermia(crude OR 2.26,95%CI 1.09-4.68;adjusted OR 2.25,95%CI 1.07-4.69).Conclusions:The findings underscore the influence of socioeconomic and occupational factors on male fertility,showing associations between lower income levels,high-risk occupations,and semen abnormalities.In contrast,lifestyle factors did not show significant associations with semen abnormalities after adjustment.Nevertheless,the current findings should be further confirmed through more extensive studies focusing on abnormal semen and lifestyle factors.
文摘The increasing dependence on fossil fuels and the consequent CO_(2)emissions have prompted urgent energy and environmental challenges[1,2].Solar-driven CO_(2)conversion into value-added fuels offers a sustainable and promising solution to these issues[3].However,the practical implementation of CO_(2)photoreduction is constrained by low efficiency,primarily due to the rapid recombination of photogenerated electron-hole pairs[4].
文摘BACKGROUND Cold-inducible RNA-binding protein(CIRP)is related to a family of stressinduced RNA-binding proteins.It is primarily found in the nucleus,where it regulates transcription.Under stress,CIRP translocates to the cytoplasm where it modulates translation;a subset is secreted as extracellular CIRP(eCIRP)which is a damage-associated molecular pattern(DAMP)molecule that stimulates the production of inflammatory mediators.Elevated blood eCIRP levels may foster immune tolerance and facilitate tumor growth.Increased CIRP levels have been noted in various malignancies including colorectal cancer(CRC).This study’s objective was to determine plasma eCIRP levels before and after minimally invasive colorectal resection(MICR)for CRC.AIM To assess plasma eCIRP levels prior to and following minimally invasive colorectal resection in the context of cancer pathology.METHODS MICR patients from an IRB-approved data/tissue bank for whom plasma samples were available were eligible.Plasma specimens were obtained preoperatively(preop)and at least 3 time’s postop[between postoperative day(POD)1-41];late samples were grouped into 7-day blocks and were considered separate time points.eCIRP levels were assessed via enzyme-linked immunosorbent assay(pg/mL)and results presented as mean±SD,analysis with Wilcoxon paired t-test.RESULTS A total of 83 CRC patients who underwent MICR[colon 66%,rectal 34%;laparoscopic-assisted(LA),70%;handassisted laparoscopic(HAL),30%]were studied.The mean preop eCIRP level was 896.8±757.0 pg/mL.Elevations in mean plasma levels(P=<0.001)were noted on POD1(2549±2632 pg/mL,n=83),POD3(1871±1362 pg/mL,n=77),POD7-13(1788±1403 pg/mL,n=57),POD14-20(1473±738.8 pg/mL,n=30),and POD21-27(1681±1375 pg/mL,n=21).No significant differences were noted at POD 28-41.Higher values were noted in the HAL’s(vs LA)group,however,there were more rectal cancers in the former.CONCLUSION Elevated plasma eCIRP levels persist for a month post MICR for CRC(change from baseline,77%-184%);highest values seen on POD1.The initial surge may be due to the acute inflammatory response while later elevations may be related to wound healing and remodeling.The higher levels noted in the HAL’s group(with greater IL and more rectal cases)suggest the extent of surgical trauma impacts eCIRP levels.Further investigations are needed.
文摘Computed tomography is an indispensable X-ray imaging modality used to diagnose numerous pathologies, but it can also involve the delivery of high ionizing radiation doses harmful to the health of patients. This study aims to survey the level of radiation doses delivered to child patients during head exams in CT imaging to set up the Dosimetric Reference Levels (DRLs), a routine dose optimization tool, based on data acquired at the University Hospital of Angré (UHA), the University Hospital of Treichville (UHT) and the Polyclinic Hospital Farah (Farah) for optimizing procedures in Ivorian hospitals. Prospectively performed on 334 CT images of 186 child patients, this study was carried out on CT systems such as Hitachi Scenaria, Sinovision Insitum, and Philips Incisive used respectively at UHA, UHT and Farah. Children’s scan data were classified into four age bands: vol or dose-length product as DLP) value, whatever the hospital, increases with respect to the age of child patients. Based on the 75th percentile of the whole dose distributions, the DRLs of the CTDIvol is 54.37 mGy whatever the age groups and those of the DLP with respect to age bands are 1224.55 mGy∙cm, 1414.06 mGy∙cm, 1632.24 mGy.cm and 1544.57 mGy∙cm, respectively. The averaged values of CTDIvol and DLP smaller than the corresponding DRLs values suggest that practices in our three facilities are optimized. However, comparing our results with those from different international studies, we see that the CTDIvol and DLP values obtained in the present work are higher. These results suggest additional surveys to ensure our DRLs values and efforts from radiologists, imaging technicians and medical physicists to strengthen clinical procedures for the radiation protection of children undergoing CT scans in Côte d’Ivoire.
文摘This study focuses on the elderly population in Xueyuan Road Street of Haidian District in Beijing.Through KANO questionnaires and the theory of attractive quality,it investigates the demand levels and degrees for different community elderly care services.It introduces the Anderson behavioral model to analyze the influencing factors,categorizes different demographics,and examines the needs of elderly individuals with varying characteristics,proposing suggestions for the improvement of future community elderly care service facilities.
基金Supported by the National Natural Science Foundation of China,No.82270942.
文摘BACKGROUND Diabetic kidney disease(DKD)has become the leading cause of end-stage renal disease.The disease characteristics,morbidity,and renal function progression rate of patients with DKD are all related to sex.This suggests that sex hormones may play an important role in changing renal function in patients with diabetes.There have been only a few studies on the correlation between sex hormones and DKD,which have contradictory conclusions.AIM To investigate the relationship between circulating sex hormone levels and DKD in men and postmenopausal women with type 2 diabetes mellitus(T2DM).METHODS This retrospective cross-sectional study included 356 patients with T2DM.Pearson or Spearman rank correlation analyses assessed the relationships between sex hormone levels and renal function indices.By adjusting for age,body mass index,systolic blood pressure,diastolic blood pressure,duration of diabetes,use of sodium-glucose cotrasporter-2 inhibitor,use of glucagon-like peptide-1 receptor agonist,hypertension,use of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker/angiotensin receptor-neprilysin inhibitor,diabetic retinopathy,diabetic peripheral vascular disease,triglyceride,uric acid,and hemoglobin A1c,multiple linear regression and logistic regression analyses were conducted to identify factors influencing the urinary albumin/creatinine ratio(UACR)and DKD.RESULTS In men,dehydroepiandrosterone sulfate levels were inversely associated with log-transformed UACR after adjustment for covariate factors[regression coefficient(β)=-0.691,95%confidence interval(CI):-1.241 to-0.141 for quartile 4 vs quartile 1;P=0.006 for trend].Elevated levels of estradiol were positively associated with DKD[odds ratio(OR)=3.097,95%CI:1.083-8.856 for quartile 4 vs quartile 1;P=0.041 for trend],and higher luteinizing hormone(LH)levels were similarly associated with DKD(OR=4.164,95%CI:1.30-13.330 for quartile 4 vs quartile 1;P=0.048 for trend).In postmenopausal women,LH levels were positively correlated with log-transformed UACR and DKD(β=1.039,95%CI:0.284-1.794 for quartile 4 vs quartile 1;P=0.006 for trend and OR=15.117,95%CI:2.191-104.326 for quartile 4 vs quartile 1;P=0.004 for trend).Follicle-stimulating hormone(FSH)levels were also positively associated with DKD(OR=9.588,95%CI:1.680-54.709 for quartile 4 vs quartile 1;P=0.014 for trend).CONCLUSION In men with T2DM,elevated levels of estradiol and LH levels were positively associated with increased risk of DKD.In postmenopausal women with T2DM,high FSH and LH levels were positively associated with increased risk of DKD.
文摘The purpose of this research was to evaluate radiological safety in pediatric radiology in hospitals in the Kongo Central province of the DRC. To this end, we surveyed a convenience sample of 50 health professionals, including 10 radiologists working in the hospitals covered by the survey, to assess the practice of pediatric radiology and the degree of compliance with radiation protection principles for the safety of children and the environment. We collected radiophysical parameters to calculate entrance doses in pediatric radiology in radiology departments to determine the dosimetric level by comparison with the diagnostic reference levels of the International Commission on Radiological Protection (ICRP). All in all, we found that in Kongo Central in the DRC, many health personnel surveyed reported that more than 30% of requested radiological examinations are not justified. Also, after comparing the entrance doses produced in the surveyed departments with those of the International Commission on Radiological Protection (ICRP), a statistically significant difference was found in pediatric radiology between the average doses in five out of six surveyed departments and those of the ICRP. Therefore, almost all of the surveyed departments were found to be highly irradiating in children, while excessive X-ray irradiation in children can have significant effects due to their increased sensitivity to radiation. Among the risks are: increased cancer risks, damage to developing cells, potential genetic effects, and neurological effects. This is why support for implementing radiation protection principles is a necessity to promote the safety of patients and the environment against the harmful effects of X-rays in conventional radiology.
基金supported by National Key Research and Development Program of China(Grant Nos.2022YFF0800903 and 2024YFC2909905)the National Natural Science Foundation of China(NSFC)(Grant Nos.42261144669,42262026,and 42273073).
文摘Metallogenic research on structural levels can reveal vertical patterns of mineralization and facilitate the deep exploration of economic minerals.However,research focusing on the correlation between structural levels and mineralization remains limited.In this study,we summarize the deformation patterns and associated mineral deposits observed at different crustal levels(i.e.,surface,shallow,middle,and deep structural levels,corresponding to depths of<2,2-8,8-15,and>15 km,respectively).Furthermore,we examine the genetic association between structural levels and metallogenesis,demonstrating that distinct structural levels are linked to specific types of mineralization.Key factors that vary across crustal levels include temperature,pressure,and fluid circulation.Ore-forming processes involve interactions between structures and fluids under varying temperatures and pressures.Structural levels influence mineralization by controlling the temperatures,pressures,and deformation mechanisms that drive the activation,migration,and enrichment of ore-forming materials.
基金Analysis of a Clinical Study of Vitamin D Supplementation in Improving the Prognosis of H-type Hypertension in the Elderly(Project No.:2341ZF140)。
文摘Objective:Correlation of serum 25-hydroxyvitamin D level with senile hypertension and its stroke.Methods:Two hundred hypertensive patients admitted to the hospital from February 2022 to December 2023 were classified as study subjects.They were divided into grade 2 hypertension group and grade 3 hypertension group,and 100 healthy medical checkups admitted during the same period were analyzed as study subjects.Results:Comparison of diagnostic results between grade 2 hypertension and grade 2 hypertensive stroke patients,there was a difference in 25(OH)D,(P<0.05).Comparison of test results between grade 3 hypertension and grade 3 hypertensive stroke patients,there was a difference in age,BMI,25(OH)D,GLU,LDL-C,(P<0.05).Serum 25-hydroxyvitamin D level is a high-risk factor for the occurrence of stroke in elderly hypertensive patients,so the probability of risk is higher,where 25(OH)D(ng/mL),GLU(mmol/L),there is a difference,(P<0.05).Conclusion:There is a greater relationship between the occurrence of stroke and serum 25-hydroxyvitamin D level in elderly hypertensive patients.The occurrence of the disease has a greater relationship with this indicator in patients and is also a high-risk factor that affects the patients’morbidity,so it is necessary to pay attention to the monitoring of this indicator after the onset of the disease in patients.
基金Research on the Implementation Path and Optimization of Labor Relations Consultation under the Platform Economy(ID:2024CSH048)a youth project of the National Social Science Fund of China.
文摘This study examines the impact of digital literacy on the levels of depressive symptoms of older adults,utilizing data from the 2022 China Family Panel Studies(CFPS).Factor analysis was used to construct digital literacy indicators,and OLS multiple linear regression modeling was carried out;the results demonstrate that digital literacy exerts a significant negative influence on depressive symptoms in older adults(β=-0.5385,p<0.01),and the findings are robust.Mechanism analysis reveals that digital literacy reduces depressive symptoms by enhancing future confidence(the mediation effect accounts for 18.0%).Heterogeneity analysis also indicates that there are more pronounced depressive symptoms-alleviating effects among male,married,and younger-old adults(aged 60-79)(p<0.01).Policy recommendations include implementing tiered digital literacy education programs with targeted support for vulnerable groups,enriching digital education resources through dedicated digital service platforms for the elderly,and strengthening psychological interventions to boost future confidence for effective depressive symptoms mitigation.
基金supported by the Scientific Research Foundation of Hainan Tropical Ocean University(No.RHDRC202312)the Major Science and Technology Project of Yazhou Bay Innovation Institute of Hainan Tropical Ocean University:Research on Hainan Coastal Marine Ecological Environment and Carbon Sink(No.2022CXYZD002).
文摘Fish scaleδ^(15)N(δ^(15)N_(sca))records trophic information of the whole life history for marine fishes.Data from gut content and values calculated from white muscle tissue(WMT)are insufficient for assessing trophic level(TL)of marine fishes as they only provide the information of several months or even several days.Stable isotope analysis(SIA)of nitrogen was carried out in fish scales and WMT of 16 species from a total of 28 individuals captured from the Yellow Sea and northern East China Sea in October and November of 2019,aiming at discovering the correlation betweenδ^(15)N_(sca) and fish WMTδ^(15)N(δ^(15)NWMT),so as to useδ^(15)N_(sca) for the characterization of TLs of marine fish.Scales were analyzed without prior carbonate dissolution as a pre-processing step.TL calculated fromδ^(15)N_(sca) was compared to traditional TL formula calculated withδ^(15)N_(WMT) to estimate the accuracy.We found that there was a highly significant and positive correlation(r=0.830,P<0.001)betweenδ^(15)N_(sca) andδ^(15)N_(WMT).TL calculation results using fish scale(TL_(sca))and WMT(TL_(WMT))showed congruence(r=0.773,P<0.001),and the regression coefficient betweenδ^(15)N_(sca) andδ^(15)NWMT was used for calculating TLsca.The conversion was conducted for the purpose of comparison with previousδ^(15)N_(WMT)-based calculation results of TL.TLsca calculation results were 81.25%within the TL range of±10%calculated withδ^(15)NWMT.The findings in the present study showed thatδ^(15)N_(sca) is a viable technique for the characterization of the TL of marine fish and can help to predict food web and support the study of marine ecosystem.
基金supported by the National Key R&D Program of China(2021YFC2600400 and 2023YFC2605200)the National Key Research Program of China(2021YFD1401100)the“San Nong Jiu Fang”Sciences and Technologies Cooperation Project of Zhejiang Province,China(2024SNJF010)。
文摘Agromyzid leafminers cause significant economic losses in both vegetable and horticultural crops,and precise assessments of pesticide needs must be based on the extent of leaf damage.Traditionally,surveyors estimate the damage by visually comparing the proportion of damaged to intact leaf area,a method that lacks objectivity,precision,and reliable data traceability.To address these issues,an advanced survey system that combines augmented reality(AR)glasses with a camera and an artificial intelligence(AI)algorithm was developed in this study to objectively and accurately assess leafminer damage in the feld.By wearing AR glasses equipped with a voice-controlled camera,surveyors can easily flatten damaged leaves by hand and capture images for analysis.This method can provide a precise and reliable diagnosis of leafminer damage levels,which in turn supports the implementation of scientifically grounded and targeted pest management strategies.To calculate the leafminer damage level,the DeepLab-Leafminer model was proposed to precisely segment the leafminer-damaged regions and the intact leaf region.The integration of an edge-aware module and a Canny loss function into the DeepLabv3+model enhanced the DeepLab-Leafminer model's capability to accurately segment the edges of leafminer-damaged regions,which often exhibit irregular shapes.Compared with state-of-the-art segmentation models,the DeepLabLeafminer model achieved superior segmentation performance with an Intersection over Union(IoU)of 81.23%and an F1score of 87.92%on leafminer-damaged leaves.The test results revealed a 92.38%diagnosis accuracy of leafminer damage levels based on the DeepLab-Leafminer model.A mobile application and a web platform were developed to assist surveyors in displaying the diagnostic results of leafminer damage levels.This system provides surveyors with an advanced,user-friendly,and accurate tool for assessing agromyzid leafminer damage in agricultural felds using wearable AR glasses and an AI model.This method can also be utilized to automatically diagnose pest and disease damage levels in other crops based on leaf images.
基金supported by the National Natural Science Foundation of China (Nos. 62222503, 52073040 and 52130304)the Sichuan Science and Technology Program (Nos. 2024NSFSC0012,2023NSFSC1973 and 2024NSFSC1446)+2 种基金the China Postdoctoral Science Foundation (Nos. 2023M740504 and GZC20230380)the Sichuan Provincial Human Resources and Social Security Department Programthe Collaborative Innovation Center of Suzhou Nano Science&Technology
文摘Triphenylamine(TPA)is the most promising donor fragment for the construction of long-wavelength thermally activated delayed fluorescence(TADF)emitters owing to its suitable dihedral angle that could enhance radiative decay to compete with the serious non-radiative decay.However,the moderate electron-donating capacity of TPA seriously limits the selection of acceptor for constructing longwavelength TADF emitters with narrow bandgaps.To address this issue,in this work,the peripheral benzene of TPA was replaced with 1,4-benzodioxane and anisole to obtain two new electrondonating units N-(2,3-dihydrobenzo[b][1,4]dioxin-6-yl)-N-phenyl-2,3-dihydrobenzo[b][1,4]dioxin-6-amine(TPADBO,−5.02 eV)and 4-methoxy-N-(4-methoxyphenyl)-N-phenylaniline(TPAMO,−5.00 eV),which possess much shallower highest occupied molecule orbital(HOMO)energy levels than the prototype TPA(−5.33 eV).Based on TPA and the modified TPA donor fragments,three TADF emitters were designed and synthesized,namely Py-TPA,Py-TPADBO and Py-TPAMO,with the same acceptor fragment 12-(2,6-diisopropylphenyl)pyrido[2′,3′:5,6]pyrazino[2,3-f][1,10]phenanthroline(Py).Among them,Py-TPAMO exhibits the highest photoluminescence quantum yield of 78.4%and the smallest singlet-triplet energy gap,which is because the introduction of anisole does not cause significant molecule deformation for the excited Py-TPAMO.And Py-TPAMO-based OLEDs successfully realize a maximum external quantum efficiency of 25.5%with the emission peak at 605 nm.This work provides a series of candidate of donor fragments for the development of efficient long-wavelength TADF emitters.
文摘BACKGROUND The central link between septic shock and acute skin failure(ASF)is the inflammatory response,which occurs throughout disease progression and can lead to systemic inflammatory response syndrome.Patients often experience bad moods,sleep disorders,and other health issues.Despite recognizing these factors,no studies have examined the correlation between inflammatory factors,lactic acid levels,ASF,mood disturbances,and sleep quality in critically ill patients.We hypothesize that higher levels of inflammatory factors and lactic acid are associated with more severe ASF and poorer mood and sleep quality,which may inform clinical treatment for septic shock and ASF.AIM To explore the relationship between inflammatory factors,lactic acid levels,the severity of ASF,bad mood,and sleep quality.METHODS The retrospective study included 150 patients with septic shock from the Second Hospital of Dalian Medical University,categorized into ASF(n=35)or non-ASF groups(n=115).We compared the peripheral blood inflammatory factors,including tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6),lactic acid levels,skin mottling score(SMS),modified early warning score(MEWS),self-rating depression scale(SDS),self-rating anxiety scale(SAS),and Pittsburgh sleep quality index(PSQI)scores.Pearson correlation analysis assessed relationships among these variables.RESULTS The ASF group had significantly higher levels of CRP(19.60±4.10 vs 15.30±2.96 mg/mL),IL-6(298.65±48.65 vs 268.66±33.66 pg/L),procalcitonin,lactic acid(8.42±2.32 vs 5.70±1.27 mmol/L),SMS[0(0,1)vs 3(2,3)],MEWS(9.34±1.92 vs 6.48±1.96),SAS(61.63±12.03 vs 53.71±12.48),SDS(60.17±12.64 vs 52.27±12.64),and PSQI scores(14.23±3.94 vs 8.69±2.46)compared with the non-ASF group(all P<0.001).Pearson correlation analysis revealed that IL-6,CRP,TNF-α,and lactic acid were positively correlated with SMS,MEWS,SAS,SDS,and PSQI scores(P<0.05).CONCLUSION Peripheral blood levels of IL-6,CRP,TNF-α,and lactic acid correlate positively with SMS,MEWS,SAS,SDS,and PSQI in critically ill patients with ASF.
文摘Objective:To explore the practical effectiveness of nursing intervention based on the theory of Gratitude Extension-Construction in improving the sense of hope in breast cancer patients.Methods:A total of 104 breast cancer patients treated in our hospital from January 2023 to May 2024 were included and divided into a control group(routine nursing,52 cases)and an observation group(routine nursing+nursing based on the theory of Gratitude Extension-Construction)using a random number table method.The Benefit Finding Scale(BFS),Hope Level Scale(HHI),and Quality of Life Questionnaire-Core 30(QLQ-C30)were used to compare and analyze the scores of the two groups before intervention,3 months after intervention,and 6 months after intervention.Results:There was no statistically significant difference in BFS,HHI,and QLQ-C30 scores between the two groups before intervention(P>0.05).Both BFS and HHI scores increased in the two groups at 3 and 6 months after intervention compared to before intervention(P<0.05),and the observation group had better BFS and HHI scores compared to the control group(P<0.05).Before intervention,there was no significant difference in QLQ-C30 scores between the two groups in all dimensions(P>0.05).Data comparison at 6 months after intervention showed that the observation group had better scores in all dimensions of QLQ-C30 than the control group(P<0.05).Conclusion:Nursing intervention based on the theory of Gratitude Extension-Construction can effectively improve the benefit-finding ability of postoperative breast cancer patients,enhance their level of hope,and improve their quality of life.It is worthy of promotion and application in clinical nursing.
文摘BACKGROUND Chronic liver disease is a growing global health problem,leading to hepatic decompensation characterized by an array of clinical and biochemical complic-ations.Several scoring systems have been introduced in assessing the severity of hepatic decompensation with the most frequent ones are Child-Pugh score,model of end-stage liver disease(MELD)score,and MELD-Na score.Anemia is frequently observed in cirrhotic patients and is linked to worsened clinical outcomes.Although studies have explored anemia in liver disease,few have investigated the correlation of hemoglobin level with the severity of hepatic decompensation.AIM To determine the relationship between hemoglobin levels and the severity of decompensated liver disease and comparing the strength of this correlation using the Child-Pugh,MELD,and MELD-Na scores.METHODS This cross-sectional study was conducted at a tertiary care hospital with 652 decompensated liver disease patients enrolled in the study.Data was collected on demographics,clinical history,and laboratory findings,including hemoglobin levels,bilirubin,albumin,prothrombin time(international normalized ratio),sodium,and creatinine.The Child-Pugh,MELD,and MELD-Na scores were calculated.Statistical analysis was performed using Statistical Package for the Social Sciences version 26,and correlations between hemoglobin levels and severity scores were assessed using Spearman's correlation coefficient.RESULTS The study included 405 males(62.1%)and 247 females(37.9%)with an average age of 58.8 years.Significant inverse correlations were found between hemoglobin levels and Child-Pugh,MELD,and MELD-Na scores(P<0.01),with the MELD scoring system being the strongest correlator among all.One-way analysis of variance revealed significant differences in hemoglobin levels across the severity groups of each scoring system(P=0.001).Tukey's post hoc analysis confirmed significant internal differences among each severity group.CONCLUSION Understanding the correlation between hemoglobin and liver disease severity can improve patient management by offering insights into prognosis and guiding treatment decisions.
基金Project supported by the National Natural Science Foundation of China (Grant Nos. 72174121 and 71774111)the Program for Professor of Special Appointment (Eastern Scholar) at Shanghai Institutions of Higher Learningthe Project for the Natural Science Foundation of Shanghai, China (Grant No. 21ZR1444100)
文摘While the interaction between information and disease in static networks has been extensively investigated,many studies have ignored the characteristics of network evolution.In this study,we construct a new two-layer coupling model to explore the interactions between information and disease.The upper layer describes the diffusion of disease-related information,and the lower layer represents the disease transmission.We then use power-law distributions to examine the influence of asymmetric activity levels on dynamic propagation,revealing a mapping relationship characterizing the interconnected propagation of information and diseases among partial nodes within the network.Subsequently,we derive the disease outbreak threshold by using the microscopic Markov-chain approach(MMCA).Finally,we perform extensive Monte Carlo(MC)numerical simulations to verify the accuracy of our theoretical results.Our findings indicate that the activity levels of individuals in the disease transmission layer have a more significant influence on disease transmission compared with the individual activity levels in the information diffusion layer.Moreover,reducing the damping factor can delay disease outbreaks and suppress disease transmission,while improving individual quarantine measures can contribute positively to disease control.This study provides valuable insights into policymakers for developing outbreak prevention and control strategies.
基金supported by a key Program of the Chongqing Scientific and Technological Commission(Grant Number.CSTB2022TIAD-KPX0165).
文摘Objectives:This study aimed to survey the geriatric nursing competencies of clinical nursing staff in Chongqing City,China,and provide suggestions to enhance these competencies.Methods:This study was conducted in 204 hospitals in Southwest China from December 24,2022 to January 7,2023.The“Geriatric Nursing Competence of Clinical Nurse Investigation Tool”was used to explore factors that influence geriatric nurses’competencies via stratified sampling.The survey was conducted by distributing and collecting questionnaires through the online platform Wenjuanxing.Results:A total of 10,692 nurses answered the questionnaires.Of these questionnaires,9,442 were valid.The total geriatric nursing competence score of the clinical nursing staff was 2.29±0.81,the secondary hospital score was 2.23±0.78,and the tertiary hospital’s overall mean score was 2.33±0.83.The factors that influenced secondary hospitals included the department of medicine,age of nurses and total length of career(P<0.05).The factors that influenced tertiary hospitals included the department of medicine,age of nurses,nurses’professional title,and geriatric practical advanced nurses’certification(P<0.05).Conclusions:Geriatric nursing competence among clinical nursing staff is imbalanced at a lower-middle level and is influenced by various factors.Thefindings highlight the need for further clinical training in geriatric nursing.The training of geriatric nurses should focus on necessary clinical skills and on preparing them to adequately manage comprehensive geriatric syndromes.
文摘A research study collected intensive longitudinal data from cancer patients on a daily basis as well as non-intensive longitudinal survey data on a monthly basis. Although the daily data need separate analysis, those data can also be utilized to generate predictors of monthly outcomes. Alternatives for generating daily data predictors of monthly outcomes are addressed in this work. Analyses are reported of depression measured by the Patient Health Questionnaire 8 as the monthly survey outcome. Daily measures include numbers of opioid medications taken, numbers of pain flares, least pain levels, and worst pain levels. Predictors are averages of recent non-missing values for each daily measure recorded on or prior to survey dates for depression values. Weights for recent non-missing values are based on days between measurement of a recent value and a survey date. Five alternative averages are considered: averages with unit weights, averages with reciprocal weights, weighted averages with reciprocal weights, averages with exponential weights, and weighted averages with exponential weights. Adaptive regression methods based on likelihood cross-validation (LCV) scores are used to generate fractional polynomial models for possible nonlinear dependence of depression on each average. For all four daily measures, the best LCV score over averages of all types is generated using the average of recent non-missing values with reciprocal weights. Generated models are nonlinear and monotonic. Results indicate that an appropriate choice would be to assume three recent non-missing values and use the average with reciprocal weights of the first three recent non-missing values.
