Objectives: To determine the level of adversity quotient and its associations with rumination, optimism, and authoritative parenting style in junior high school students. Adversity quotient is the adaptation ability t...Objectives: To determine the level of adversity quotient and its associations with rumination, optimism, and authoritative parenting style in junior high school students. Adversity quotient is the adaptation ability to overcome problems and obstacles with a positive attitude. Early adolescence, as a critical stage of life, needs to cultivate adversity quotient. However, adversity quotient and its influencing factors in adolescents have not been fully understood. Methods: A total of 129 students from 3 junior high schools (grade 7-9) in Chon Buri province, Thailand, were randomly recruited to participate in this correlational research study. They completed 5 questionnaires including the demographic form, adversity quotient assessment, authoritative parenting style, optimism, and rumination. Descriptive statistics and Pearson’s correlation coefficient were used for data analysis. Results: Adversity quotient was at a moderate level with a mean of 138.78 (standard deviation [SD] = 21.25). Adversity quotient was significantly, positively correlated with authoritative parenting at the highest level (r = 0.60), followed by optimism at a moderate level (r = 0.38), and rumination at a low level (r = 0.25, P < 0.01). Conclusions: All parties responsible for early adolescents’ development should enhance the adversity quotient to a higher level through campaigns promoting authoritative parenting and optimism. An unexpected positive correlation between adversity quotient and rumination warrants cautious interpretation and more studies.展开更多
BACKGROUND Depression is a common mental disorder among adolescents,characterized by a high rate of suicide and self-harm,which not only is devastating to families but also has a negative impact on society.Psychologic...BACKGROUND Depression is a common mental disorder among adolescents,characterized by a high rate of suicide and self-harm,which not only is devastating to families but also has a negative impact on society.Psychological factors such as impulsive personality,perceived chronic social adversity(PCSA),and sense of security are closely associated with suicide risk in adolescents with depression.Few studies have been conducted on the relationship between these factors.AIM To explore the impact of impulsive personality on suicide risk in adolescents with depression and the chain mediating effect between PCSA and sense of security.METHODS This study is a retrospective study.A total of 200 adolescents with depression who visited the Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital from January 2021 to December 2023 comprised the study cohort.The PCSA scale,Security Questionnaire,Barratt Impulsiveness Scale,and Beck Scale for Suicide Ideation were used to evaluate depression.RESULTS Suicide risk was positively correlated with impulsive personality and PCSA(P<0.05),whereas sense of security was negatively correlated with suicide risk,impulsive personality,and PCSA(P<0.05).The total indirect effect of PCSA and sense of security on impulsive personality and suicide risk was 35.43%,with the mediating effect of PCSA and sense of security contributing 16.53%and 15.75%,respectively.PCSA and sense of security exhibited a chain mediating effect between impulsive personality and suicide risk,accounting for 3.15%.CONCLUSION The suicide risk of adolescents with depression is significantly associated with impulsive personality,PCSA,and sense of security.Impulsive personality affects the suicide risk of adolescents with depression both directly and indirectly,with the latter occurring via PCSA and sense of security.展开更多
BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery ...BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery and long-term survival.Accurate preoperative identification of high-risk patients is critical for improving outcomes.AIM To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.METHODS This retrospective study included 747 patients who underwent MIE at two centers from January 2019 to February 2024.Patients were separated into a train set(n=549)and a validation set(n=198).After screening by least absolute shrinkage and selection operator regression,multivariate logistic regression analyzed clinical and intraoperative variables to identify independent risk factors for SAEs.A risk stratification model was constructed and validated to predict the probability of SAEs.RESULTS SAEs occurred in 10.2%of patients in train set and 13.6%in the validation set.Patients with SAE had significantly higher complication rate and a longer hospital stay after surgery.The key independent risk factors identified included chronic obstructive pulmonary disease,a history of alcohol consumption,low forced expiratory volume in the first second,and low albumin levels.The stratification model has excellent prediction accuracy,with an area under the curve of 0.889 for the training set and an area under the curve of 0.793 for the validation set.CONCLUSION The developed risk stratification model effectively predicts the risk of SAEs in patients undergoing MIE,facilitating targeted preoperative interventions and improving perioperative management.展开更多
Background: Exposure to adverse childhood experiences (ACEs) is associated with a higher likelihood of developing psychological disorders among adolescents. The current study aimed to analyze the effect of independent...Background: Exposure to adverse childhood experiences (ACEs) is associated with a higher likelihood of developing psychological disorders among adolescents. The current study aimed to analyze the effect of independent and cumulative effects of ACEs exposure on the likelihood of Posttraumatic Stress Disorder (PTSD) and a Complex PTSD (CPSTD) diagnosis in Indian adolescents. Methods: A sample of 411 schoolchildren participated in the study. It was collected data on exposure to ACEs, PTSD, CPTSD, and attachment styles. Results: It was found that exposure to bullying and threats of violence was significantly associated with PTSD and CPTSD diagnosis, and exposure to physical violence and serious illness was associated with CPTSD diagnosis. Exposure to one ACE and exposure to 2 - 3 ACEs were associated with PTSD and CPTSD diagnosis, while exposure to 4 - 5 ACEs was associated with CPTSD diagnosis. Preoccupied and fearful attachment styles were significantly associated with PTSD and CPTSD diagnosis. Conclusion: The results of the study suggest that biological, psychological, and social factors interact and contribute to the differential prevalence of ACE, attachment styles, and PTSD/CPTSD. This study emphasizes the need of addressing childhood trauma as a public health priority in India.展开更多
Paclitaxel is one of the commonly used drugs in postoperative chemotherapy for ovarian cancer patients. However, affected by drug dosage and individual differences in the course of medication, patients will have diffe...Paclitaxel is one of the commonly used drugs in postoperative chemotherapy for ovarian cancer patients. However, affected by drug dosage and individual differences in the course of medication, patients will have different degrees of adverse reactions, which will cause damage to the patient’s body once they occur. This paper retrospectively analyzed the clinical data of patients with severe allergic reactions such as fecal incontinence and numbness of hands and feet caused by the use of paclitaxel liposome during postoperative chemotherapy in a case of ovarian cancer admitted to our hospital. The causes and corresponding treatment measures were analyzed, in order to provide the reference for medical staff to take effective countermeasures in advance in the future.展开更多
BACKGROUND Increasing evidence has shown an increased risk of non-suicidal self-injury(NSSI)in left-behind children and adolescents(LBCAs).However,a systematic summary of studies comparing the risk of NSSI between LBC...BACKGROUND Increasing evidence has shown an increased risk of non-suicidal self-injury(NSSI)in left-behind children and adolescents(LBCAs).However,a systematic summary of studies comparing the risk of NSSI between LBCAs and non-LBCAs in China is lacking.AIM To investigate the risk of NSSI among LBCAs in China.METHODS We performed a systematic search of Embase,PubMed,and Web of Science from initiation to October 25,2024,for all relevant studies of NSSI and LBCAs.The effect sizes were reported as odds ratios(ORs)with 95%confidence intervals(CI).Sensitivity analyses were conducted to further confirm the stability of the findings.RESULTS A total of 10 studies with 165276 children and adolescents were included in this study.LBCAs had significantly higher rates of NSSI compared with non-LBCAs(OR=1.33,95%CI:1.19-1.49),with high heterogeneity observed(I^(2)=77%,P<0.001).Further sensitivity analyses were consistent with the primary analysis(OR=1.29,95%CI:1.21-1.39,I^(2)=0%).CONCLUSION LBCAs are found to be at an increased risk of NSSI compared with children and adolescents of non-migrants.More attention and intervention are urgently needed for LBCAs,especially those living in developing countries.展开更多
Objective:Despite established associations between certain medications and urticaria,the risk profiles of most pharmaceutical agents remain poorly characterized.This investigation aimed to identify risk factors for me...Objective:Despite established associations between certain medications and urticaria,the risk profiles of most pharmaceutical agents remain poorly characterized.This investigation aimed to identify risk factors for medication-induced urticaria through comprehensive analysis of the FDA Adverse Event Reporting System(FAERS)database.Methods:We employed reporting odds ratios(ROR)to evaluate drug-urticaria associations using FAERS data spanning from Q12004 to Q32024.Analytical approaches included univariate screening,LASSO regression,and multivariate logistic regression to identify potential risk factors.Multiple comparison adjustments were implemented using the Bonferroni method.Results:The study identified 1807 pharmaceutical agents potentially associated with urticaria development.Univariate analysis categorized these agents into several therapeutic classes:antimicrobials(19/85),biologics(16/85),analgesics(8/85),dermatologicals(3/85),anti-rheumatic agents(4/85),hormonal preparations(3/85),antihypertensives(2/85),neuropsychiatric medications(2/85),uric acid-lowering drugs(2/85),multiple sclerosis therapies(2/85),and miscellaneous agents(17/85).Multivariate analysis identified three significant risk determinants:middle-aged individuals(36-53 years),female gender,and exposure to any of 82 specific medications.Conclusion:These evidence-based findings provide valuable insights for early clinical recognition of drug-induced urticaria and establish a foundation for subsequent mechanistic investigations into medication-related hypersensitivity reactions.展开更多
Objectives:Suicidal ideation is a strong predictor of suicide deaths,which refers to the consideration or desire to give up one's own life.Left-behind children in rural China are more vulnerable to psychological p...Objectives:Suicidal ideation is a strong predictor of suicide deaths,which refers to the consideration or desire to give up one's own life.Left-behind children in rural China are more vulnerable to psychological problems and suicidal ideation compared to their non-left-behind peers.The aim of the current study was to examine two potential protective factors,negotiable fate belief and coping self-efficacy,and to test the mediating role of coping self-efficacy in the relationship between negotiable fate belief and suicidal ideation.We also analyzed gender differences in this mediation model.Methods:Across-sectional survey was conducted in rural areas ofChina.A sample of 526 left-behind children(285 males,54.18%;241 females,45.82%;Meanage=13.29 years,SD=0.97 years)was recruited to complete the Negotiable Fate Belief Scale,Coping Self-Efficacy Scale,and the Positive and Negative Suicide Ideation Inventory-Negative Scale.We used structural equation modeling to test the mediation model and multigroup analysis to test the moderation effect of gender.Results:Negotiable fate belief is negatively correlated with suicidal ideation(r=-0.13,p<0.01).Moreover,coping self-efficacy mediates the relationship between negotiable fate belief and suicidal ideation(β=-0.06,95%confidence interval(CI)[-0.12,-0.02]),accounting for 35.29%of the total effect.Finally,the mediating effect of coping self-efficacy was found to be significant only for female left-behind children(male:95%CI[-0.09,0.07];female:95%CI[-0.16,-0.01]).For female left-behind children,the mediating effect was complete,with a coefficient of-0.06,accounting for 85.71%of the total effect.Conclusions:The relationship between negotiable fate belief and suicidal ideation among rural left-behind children is mediated by coping self-efficacy,and this mediation effect was moderated by gender.This study provides a theoretical explanation for how cultivating the belief in negotiable fate and coping self-efficacy is effective for reducing suicidal ideation of rural left-behind children.展开更多
Atopic dermatitis(AD)is one of the most common chronic inflammatory skin diseases.It usually develops in childhood and may persist into adulthood.Dupilumab is a fully human monoclonal antibody directed against interle...Atopic dermatitis(AD)is one of the most common chronic inflammatory skin diseases.It usually develops in childhood and may persist into adulthood.Dupilumab is a fully human monoclonal antibody directed against interleukin-4R-alpha,the common chain of interleukin-4 and interleukin-13 receptors.Dupilumab showed clinical improvements in patients with atopic dermatitis,asthma,and chronic rhinosinusitis and is currently under development for other indications.However,there are many adverse effects reported after dupilumab therapy including local injection site reactions,conjunctivitis,headache,and nasopharyngitis.We report a new case of a 4-year-old child who experienced anaphylaxis after dupilumab injection.In addition to,we summary and disscuss the rare adverse reactions caused by dupilumab injection by searching the literature in pubmed.展开更多
BACKGROUND Intra-arterial chemotherapy(IAC)has become a first-line standard treatment for retinoblastoma(RB).However,studies describing its adverse events are sparse,especially from the developing world.Our study desc...BACKGROUND Intra-arterial chemotherapy(IAC)has become a first-line standard treatment for retinoblastoma(RB).However,studies describing its adverse events are sparse,especially from the developing world.Our study described the outcomes and adverse events from a single center in South India.AIM To describe the challenges,treatment outcomes,and complications of selective IAC for RB in Indian eyes.METHODS This study was a single center,retrospective study that included 17 patients with RB who underwent IAC using melphalan(5/7.5 mg)and topotecan(1/2 mg)(n=12)or melphalan(5 mg)alone(n=3)or triple therapy that included carboplatin(30 mg)along with these drugs(n=2)between January 2018 and December 2023.In all,17 IAC procedures were performed using selective ophthalmic artery cannulation.Treatment outcomes were evaluated in terms of tumor control,vitreous and subretinal seed control,complications,and globe salvage rates.RESULTS Out of the 17 patients,11 were diagnosed with unilateral RB and 6 were diag-nosed with bilateral RB.The mean age at the time of diagnosis was 19.8 months.The mean interval between the first symptom and presentation was 6.5 months.IAC was employed as the primary(n=9)or secondary(n=8)modality of treatment.Each eye received a mean of 1.5 IAC sessions(median:1 session;range:1-3 sessions).Eyes were classified according to the international classification of RB as group B(n=5),group C(n=1),group D(n=4),and group E(n=7).Following IAC,complete regression of the main tumor was seen in 15 eyes(88%)and partial regression in 2 eyes(12%).Globe salvage was achieved in 15 eyes(88%).Adverse effects included vitreous hemorrhage(n=3),rhegmatogenous retinal de-tachment(n=2),choroidal ischemia(n=1),isolated subretinal hemorrhage(n=2),retinal pigment epithelium degeneration(n=2),forehead pigmentation(n=1),third nerve palsy with complete ptosis(n=1),and 30-degree exotropia(n=1).The mean follow-up period was 28.6 months(median:24 months,range:1–72 months).CONCLUSION IAC is an effective way to control RB and globe preservation.In the Indian context we encountered many cha-llenges highlighting the importance of case selection.Further studies in India are required to thoroughly un-derstand IAC as a treatment for RB.展开更多
Objective:To explore the adverse reactions associated with antibiotics and analyze strategies for their rational use.Methods:A retrospective analysis was conducted on 60 patients who experienced adverse reactions to a...Objective:To explore the adverse reactions associated with antibiotics and analyze strategies for their rational use.Methods:A retrospective analysis was conducted on 60 patients who experienced adverse reactions to antibiotics between August 2021 and August 2023.The types of antibiotics that caused adverse reactions were analyzed,and the symptoms of adverse reactions and measures for rational use of antibiotics were summarized.Results:Among the analyzed cases of adverse reactions to antibiotics,the highest rate was observed in patients aged 61–75 years,accounting for 38.33%,followed by patients aged 51–60 years,accounting for 20.00%.In terms of the types of antibiotics that caused adverse reactions,cephalosporins were the most common,accounting for 40.00%,followed by penicillins,accounting for 18.33%.Analysis of the systems involved in adverse reactions showed that skin and appendage disorders were the most common,accounting for 36.67%,followed by the digestive system,accounting for 28.33%.Conclusion:Irrational use of antibiotics can lead to adverse drug reactions.Therefore,it is necessary to analyze strategies for the rational use of antibiotics to reduce adverse drug reactions and ensure the safety of antibiotic use.展开更多
The aim of this study is to evaluate the characteristics and patterns of adverse drug reactions(ADRs)associated with antineoplastic drugs and provide insights for safer chemotherapy practices.Based on 979 ADR cases re...The aim of this study is to evaluate the characteristics and patterns of adverse drug reactions(ADRs)associated with antineoplastic drugs and provide insights for safer chemotherapy practices.Based on 979 ADR cases reported in our hospital from January 1,2022,to December 31,2023,an analysis was conducted.Statistical analysis of the data revealed that 72.73%of these ADR incidents occurred in a hospital setting.The incidence of ADRs was higher in female patients compared to males,with the majority of cases(59.14%)observed in individuals aged 51-70 years.Intravenous administration was the predominant route linked to ADRs,accounting for 69.66%of the cases.Serious ADRs represented 9.30%of the total,including one instance where symptoms did not improve despite drug discontinuation or treatment.Cytotoxic antineoplastic drugs were responsible for 97.85%of all ADRs,with oxaliplatin being the most frequently implicated agent(19.82%).Gastrointestinal system involvement was the most common ADR manifestation,observed in 60.79%of cases.These findings underscored the necessity of enhanced monitoring for ADRs associated with cytotoxic antineoplastic drugs,particularly platinum-based agents.Comprehensive risk assessments and tailored treatment plans should be implemented during chemotherapy to minimize the occurrence of ADRs and safeguard patient safety.展开更多
Background Non-suicidal self-injury(NSSI)is a significant health concern among adolescents and young adults,often resulting from adverse childhood experiences(ACEs).Dissociation,post-traumatic symptoms and attachment ...Background Non-suicidal self-injury(NSSI)is a significant health concern among adolescents and young adults,often resulting from adverse childhood experiences(ACEs).Dissociation,post-traumatic symptoms and attachment style may have a role in shaping such associations.Aims This study aims to provide a unified model of the impact of ACEs on NSSI,exploring complex post-traumatic stress disorder(cPTSD)symptoms and dissociation as potential mediators and the role of the predominant attachment style in affecting such associations.Methods 1010 young individuals attending the last year of high school participated in this cross-sectional study.ACEs,cPTSD,dissociation and NSSI were evaluated using self-report questionnaires.We fitted a path model of NSSI,with ACEs as exogenous variables and cPTSD and dissociation as sequential mediators.Secure,fearful and preoccupied attachment styles were modelled as grouping variables.Results Our findings showed that dissociation mediated the impact of ACEs on NSSI in subjects with a fearful attachment style,as opposed to those with a preoccupied attachment for whom cPTSD symptoms mediated the ACEs-NSSI association.Conclusions Attachment styles moderate the relationship between ACEs and NSSI,with either dissociation or post-traumatic symptomatology mediating the impact of ACEs on NSSI,depending on the predominant attachment style.Our results highlight the importance of attachment as a pathway modifier in the relationships between different psychopathology dimensions,providing a useful framework to better conceptualise the ACEs-NSSI association.展开更多
Objective:To utilize the VigiAccess database for data mining to analyze the characteristics of adverse reactions induced by mirogabalin,providing critical information for clinical medication use.Method:This study anal...Objective:To utilize the VigiAccess database for data mining to analyze the characteristics of adverse reactions induced by mirogabalin,providing critical information for clinical medication use.Method:This study analyzed data from the VigiAccess database,filtering out adverse reaction reports where mirogabalin was identified as the Primary Suspect Drug(PS).Reporting Odds Ratio(ROR),Proportional Reporting Ratio(PRR),Bayesian Confidence Propagation Neural Network(BCPNN),and Empirical Bayes Geometric Mean(EBGM)methods were employed as data mining algorithms for pharmacovigilance and adverse event monitoring.These methods identify potential drug-adverse event association signals by analyzing the relationship between drug use and adverse event reporting.ROR and PRR focus on calculating reporting ratios,while BCPNN and EBGM use neural networks and empirical Bayes models,respectively,to enhance the accuracy and reliability of signal detection.Results:A total of 734 adverse reaction reports associated with mirogabalin were obtained.The results showed that females reported the highest number of adverse reactions,accounting for 59.67%,while males accounted for 38.83%.In terms of age distribution,the highest number of reports came from individuals over 75 years old,accounting for 33.79%.Adverse reactions mainly involved the nervous system(33.45%),general diseases and reactions at the site of administration(11.62%),and gastrointestinal disorders(10.74%).The most common adverse reactions included dizziness(11.62%),somnolence(8.27%),renal dysfunction(2.90%),and edema(2.82%).Signal intensity analysis revealed that certain adverse reactions(such as renal dysfunction,rhabdomyolysis,and drug-induced liver injury)had significant signal strength,suggesting a strong association with mirogabalin.Conclusion:This study,through signal mining of the VigiAccess database,reveals the characteristics of mirogabalin’s adverse reactions in the real world,particularly in the nervous system and renal function.These findings provide important reference information for clinicians,aiding in the optimization of the safe use of mirogabalin.Future research should further validate the causal relationships of these signals and explore individualized treatment strategies to reduce the incidence of adverse reactions and improve patient outcomes.展开更多
Monitoring adverse drug reactions(ADRs)in primary medical institutions is crucial to ensuring medication safety.Currently,this work faces difficulties such as insufficient professional ability of staff,imperfect monit...Monitoring adverse drug reactions(ADRs)in primary medical institutions is crucial to ensuring medication safety.Currently,this work faces difficulties such as insufficient professional ability of staff,imperfect monitoring systems,and low patient awareness.It is necessary to improve the level of ADR monitoring at the grassroots level and ensure the safety and effectiveness of medication through countermeasures such as strengthening personnel training,optimizing monitoring processes,and raising public awareness.展开更多
Obesity is a global pandemic that has been threatening the worldwide population.It has been reported to be associated with an increase in the risk of chronic diseases such as type 2 diabetes mellitus(T2DM),cardiovascu...Obesity is a global pandemic that has been threatening the worldwide population.It has been reported to be associated with an increase in the risk of chronic diseases such as type 2 diabetes mellitus(T2DM),cardiovascular disease,and other diseases,including some malignancies.Currently,the first line of management includes lifestyle modifications.However,recently,bariatric surgeries were introduced to combat obesity.The previous modalities of management are always challenging since lifestyle could have limited long-term effectiveness and difficulty to achieve,and surgeries are invasive and also require a lifestyle modification and commitment.Glucagon-like peptide-1 receptor agonists(GLP-1RAs)were initially introduced as a rising star for managing T2DM,with patients benefiting from the control of blood sugar and weight loss.These medications work by enhancing feelings of fullness,slowing down digestion,and ultimately reducing calorie intake.However,GLP-1RAs are not without side effects and have some costs.Common side effects include gastrointestinal(GI)adverse events such as nausea,vomiting,diarrhea,and a lack of GI motility,which is the main mechanism through which the drug induces a feeling of fullness and promotes weight loss,potentially resulting in treatment discontinuation.More serious,though less frequent,risks include pancreatitis,gallbladder diseases,and,rarely,thyroid Ccell cancers.This review aimed to discuss the globally emerging role of GLP-1RAs in obesity management and highlight some safety considerations for patients taking these drugs.展开更多
Existing evidence has demonstrated the association between exposure to volatile organic compounds(VOCs)and osteoporosis(OP)risk,but the underlying mechanistic framework remains unclear.This study aimed to explore pote...Existing evidence has demonstrated the association between exposure to volatile organic compounds(VOCs)and osteoporosis(OP)risk,but the underlying mechanistic framework remains unclear.This study aimed to explore potential pathways using adverse outcome pathway(AOP)analysis,and evidence this association in middle-to-old-aged American adults using the updated National Health and Nutrition Examination Survey data.Multivariable-adjusted general linear and weighted quantile sum models were employed to analyze associations of VOC metabolites(VOCMs),representing internal VOCs exposure levels,with OP-related phenotypes.An AOP framework based on network analysis was developed by extracting target genes and phenotypes.Among 3555 American adults aged≥40 years(539 OP participants),we found that increasing urinary 3-and 4-methylhippuric acid,N-acetyl-S-(n-propyl)-l-cysteine(BPMA),and N-acetyl-S-(3-hydroxypropyl)-l-cysteine were associated with elevated OP odds with odds ratios(ORs)(95%confidence intervals,95%CIs)being 1.254(1.016 to 1.548),1.182(1.014 to 1.377),and 1.244(1.029 to 1.505),respectively,per standard deviation.Urinary BPMA and N-acetyl-S-(2-cyanoethyl)-l-cysteine were inversely associated with lumbar spine bone mineral density(BMD),while urinary N-acetyl-S-(2-hydroxypropyl)-l-cysteine was positively associated with hip BMD.Additionally,OP odds increased by 46.0%(95%CI:3.9%to 105.1%)per quartile increment in the VOC mixture.AOP analysis identified 53 target genes and 9 target phenotypes,and 5 of 9 target phenotypes were oxidative stress(OS)-related.Literature and the“AOP 482”framework implied the core role of OS in the VOC exposure and prevalent OP association,with the interleukin-6 as themolecular initiating event.Our findings provided a theoretical basis for further investigation.展开更多
BACKGROUND In randomized controlled trials(RCTs),the placebo arm has often been ignored as the attention tends to be focused on the treatment arm.We undertook a meta-analysis based on the data from the placebo arm in ...BACKGROUND In randomized controlled trials(RCTs),the placebo arm has often been ignored as the attention tends to be focused on the treatment arm.We undertook a meta-analysis based on the data from the placebo arm in RCTs of hepatocellular carci-noma(HCC),the response rates and survival status,and adverse events(AEs)were summarized and evaluated.AIM To systematically evaluate the response rates,survival status and AEs in the placebo arms of RCTs for HCC.METHODS A systematic search was performed on PubMed,Ovid MEDLINE,Embase and Cochrane Library to identify relevant trials evaluating the efficacy of drugs for the treatment of HCC,published until December 31,2023.Statistical analysis was performed using R statistical software(version 4.3.2).RESULTS A total of 18 RCTs,involving 2390 patients,met the criteria for inclusion in the meta-analysis.The pooled overall disease control rate and objective response rate in the placebo group were 38%[95%confidence interval(CI):33%-42%]and 1%(95%CI:1%-2%),respectively.Overall survival and progression-free survival in the placebo group were 7.9 months(95%CI:7.6-8.31 months)and 1.9 months(95%CI:1.6-2.1 months),respectively.The incidence of grade 3 or 4 AEs was 37%(95%CI:30%-43%).Additionally,the incidence of interruptions or dose reductions due to AEs was 20%(95%CI:13%-27%),while the incidence of treatment discontinuation due to AEs was 9%(95%CI:6%-12%).CONCLUSION Over one-third of advanced HCC patients exhibit therapy-free disease control,with placebo-arm AEs observed.These findings guide single-arm trials design and enhance patient acceptance of anticancer therapies.展开更多
Geological analysis,despite being a long-term method for identifying adverse geology in tunnels,has significant limitations due to its reliance on empirical analysis.The quantitative aspects of geochemical anomalies a...Geological analysis,despite being a long-term method for identifying adverse geology in tunnels,has significant limitations due to its reliance on empirical analysis.The quantitative aspects of geochemical anomalies associated with adverse geology provide a novel strategy for addressing these limitations.However,statistical methods for identifying geochemical anomalies are insufficient for tunnel engineering.In contrast,data mining techniques such as machine learning have demonstrated greater efficacy when applied to geological data.Herein,a method for identifying adverse geology using machine learning of geochemical anomalies is proposed.The method was identified geochemical anomalies in tunnel that were not identified by statistical methods.We by employing robust factor analysis and self-organizing maps to reduce the dimensionality of geochemical data and extract the anomaly elements combination(AEC).Using the AEC sample data,we trained an isolation forest model to identify the multi-element anomalies,successfully.We analyzed the adverse geological features based the multi-element anomalies.This study,therefore,extends the traditional approach of geological analysis in tunnels and demonstrates that machine learning is an effective tool for intelligent geological analysis.Correspondingly,the research offers new insights regarding the adverse geology and the prevention of hazards during the construction of tunnels and underground engineering projects.展开更多
基金supported by the Faculty of Nursing Burapha University(No.19/2561).
文摘Objectives: To determine the level of adversity quotient and its associations with rumination, optimism, and authoritative parenting style in junior high school students. Adversity quotient is the adaptation ability to overcome problems and obstacles with a positive attitude. Early adolescence, as a critical stage of life, needs to cultivate adversity quotient. However, adversity quotient and its influencing factors in adolescents have not been fully understood. Methods: A total of 129 students from 3 junior high schools (grade 7-9) in Chon Buri province, Thailand, were randomly recruited to participate in this correlational research study. They completed 5 questionnaires including the demographic form, adversity quotient assessment, authoritative parenting style, optimism, and rumination. Descriptive statistics and Pearson’s correlation coefficient were used for data analysis. Results: Adversity quotient was at a moderate level with a mean of 138.78 (standard deviation [SD] = 21.25). Adversity quotient was significantly, positively correlated with authoritative parenting at the highest level (r = 0.60), followed by optimism at a moderate level (r = 0.38), and rumination at a low level (r = 0.25, P < 0.01). Conclusions: All parties responsible for early adolescents’ development should enhance the adversity quotient to a higher level through campaigns promoting authoritative parenting and optimism. An unexpected positive correlation between adversity quotient and rumination warrants cautious interpretation and more studies.
文摘BACKGROUND Depression is a common mental disorder among adolescents,characterized by a high rate of suicide and self-harm,which not only is devastating to families but also has a negative impact on society.Psychological factors such as impulsive personality,perceived chronic social adversity(PCSA),and sense of security are closely associated with suicide risk in adolescents with depression.Few studies have been conducted on the relationship between these factors.AIM To explore the impact of impulsive personality on suicide risk in adolescents with depression and the chain mediating effect between PCSA and sense of security.METHODS This study is a retrospective study.A total of 200 adolescents with depression who visited the Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital from January 2021 to December 2023 comprised the study cohort.The PCSA scale,Security Questionnaire,Barratt Impulsiveness Scale,and Beck Scale for Suicide Ideation were used to evaluate depression.RESULTS Suicide risk was positively correlated with impulsive personality and PCSA(P<0.05),whereas sense of security was negatively correlated with suicide risk,impulsive personality,and PCSA(P<0.05).The total indirect effect of PCSA and sense of security on impulsive personality and suicide risk was 35.43%,with the mediating effect of PCSA and sense of security contributing 16.53%and 15.75%,respectively.PCSA and sense of security exhibited a chain mediating effect between impulsive personality and suicide risk,accounting for 3.15%.CONCLUSION The suicide risk of adolescents with depression is significantly associated with impulsive personality,PCSA,and sense of security.Impulsive personality affects the suicide risk of adolescents with depression both directly and indirectly,with the latter occurring via PCSA and sense of security.
基金Supported by Joint Funds for the Innovation of Science and Technology,Fujian Province,No.2023Y9187 and No.2021Y9057.
文摘BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery and long-term survival.Accurate preoperative identification of high-risk patients is critical for improving outcomes.AIM To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.METHODS This retrospective study included 747 patients who underwent MIE at two centers from January 2019 to February 2024.Patients were separated into a train set(n=549)and a validation set(n=198).After screening by least absolute shrinkage and selection operator regression,multivariate logistic regression analyzed clinical and intraoperative variables to identify independent risk factors for SAEs.A risk stratification model was constructed and validated to predict the probability of SAEs.RESULTS SAEs occurred in 10.2%of patients in train set and 13.6%in the validation set.Patients with SAE had significantly higher complication rate and a longer hospital stay after surgery.The key independent risk factors identified included chronic obstructive pulmonary disease,a history of alcohol consumption,low forced expiratory volume in the first second,and low albumin levels.The stratification model has excellent prediction accuracy,with an area under the curve of 0.889 for the training set and an area under the curve of 0.793 for the validation set.CONCLUSION The developed risk stratification model effectively predicts the risk of SAEs in patients undergoing MIE,facilitating targeted preoperative interventions and improving perioperative management.
文摘Background: Exposure to adverse childhood experiences (ACEs) is associated with a higher likelihood of developing psychological disorders among adolescents. The current study aimed to analyze the effect of independent and cumulative effects of ACEs exposure on the likelihood of Posttraumatic Stress Disorder (PTSD) and a Complex PTSD (CPSTD) diagnosis in Indian adolescents. Methods: A sample of 411 schoolchildren participated in the study. It was collected data on exposure to ACEs, PTSD, CPTSD, and attachment styles. Results: It was found that exposure to bullying and threats of violence was significantly associated with PTSD and CPTSD diagnosis, and exposure to physical violence and serious illness was associated with CPTSD diagnosis. Exposure to one ACE and exposure to 2 - 3 ACEs were associated with PTSD and CPTSD diagnosis, while exposure to 4 - 5 ACEs was associated with CPTSD diagnosis. Preoccupied and fearful attachment styles were significantly associated with PTSD and CPTSD diagnosis. Conclusion: The results of the study suggest that biological, psychological, and social factors interact and contribute to the differential prevalence of ACE, attachment styles, and PTSD/CPTSD. This study emphasizes the need of addressing childhood trauma as a public health priority in India.
文摘Paclitaxel is one of the commonly used drugs in postoperative chemotherapy for ovarian cancer patients. However, affected by drug dosage and individual differences in the course of medication, patients will have different degrees of adverse reactions, which will cause damage to the patient’s body once they occur. This paper retrospectively analyzed the clinical data of patients with severe allergic reactions such as fecal incontinence and numbness of hands and feet caused by the use of paclitaxel liposome during postoperative chemotherapy in a case of ovarian cancer admitted to our hospital. The causes and corresponding treatment measures were analyzed, in order to provide the reference for medical staff to take effective countermeasures in advance in the future.
基金Supported by the Fujian Provincial Health and Family Planning Youth Scientific Research Project,No.2022QNB029.
文摘BACKGROUND Increasing evidence has shown an increased risk of non-suicidal self-injury(NSSI)in left-behind children and adolescents(LBCAs).However,a systematic summary of studies comparing the risk of NSSI between LBCAs and non-LBCAs in China is lacking.AIM To investigate the risk of NSSI among LBCAs in China.METHODS We performed a systematic search of Embase,PubMed,and Web of Science from initiation to October 25,2024,for all relevant studies of NSSI and LBCAs.The effect sizes were reported as odds ratios(ORs)with 95%confidence intervals(CI).Sensitivity analyses were conducted to further confirm the stability of the findings.RESULTS A total of 10 studies with 165276 children and adolescents were included in this study.LBCAs had significantly higher rates of NSSI compared with non-LBCAs(OR=1.33,95%CI:1.19-1.49),with high heterogeneity observed(I^(2)=77%,P<0.001).Further sensitivity analyses were consistent with the primary analysis(OR=1.29,95%CI:1.21-1.39,I^(2)=0%).CONCLUSION LBCAs are found to be at an increased risk of NSSI compared with children and adolescents of non-migrants.More attention and intervention are urgently needed for LBCAs,especially those living in developing countries.
文摘Objective:Despite established associations between certain medications and urticaria,the risk profiles of most pharmaceutical agents remain poorly characterized.This investigation aimed to identify risk factors for medication-induced urticaria through comprehensive analysis of the FDA Adverse Event Reporting System(FAERS)database.Methods:We employed reporting odds ratios(ROR)to evaluate drug-urticaria associations using FAERS data spanning from Q12004 to Q32024.Analytical approaches included univariate screening,LASSO regression,and multivariate logistic regression to identify potential risk factors.Multiple comparison adjustments were implemented using the Bonferroni method.Results:The study identified 1807 pharmaceutical agents potentially associated with urticaria development.Univariate analysis categorized these agents into several therapeutic classes:antimicrobials(19/85),biologics(16/85),analgesics(8/85),dermatologicals(3/85),anti-rheumatic agents(4/85),hormonal preparations(3/85),antihypertensives(2/85),neuropsychiatric medications(2/85),uric acid-lowering drugs(2/85),multiple sclerosis therapies(2/85),and miscellaneous agents(17/85).Multivariate analysis identified three significant risk determinants:middle-aged individuals(36-53 years),female gender,and exposure to any of 82 specific medications.Conclusion:These evidence-based findings provide valuable insights for early clinical recognition of drug-induced urticaria and establish a foundation for subsequent mechanistic investigations into medication-related hypersensitivity reactions.
基金funded by the 2023Laibin City Philosophy and Social Science Research Project(No.2023LBZS035)2024Guangxi Student Innovation and Entrepreneurship Training Program Project(No.S202411546046X)2025 Research Project of Guangxi Science&Technology Normal University(No.GXKS2025YB020).
文摘Objectives:Suicidal ideation is a strong predictor of suicide deaths,which refers to the consideration or desire to give up one's own life.Left-behind children in rural China are more vulnerable to psychological problems and suicidal ideation compared to their non-left-behind peers.The aim of the current study was to examine two potential protective factors,negotiable fate belief and coping self-efficacy,and to test the mediating role of coping self-efficacy in the relationship between negotiable fate belief and suicidal ideation.We also analyzed gender differences in this mediation model.Methods:Across-sectional survey was conducted in rural areas ofChina.A sample of 526 left-behind children(285 males,54.18%;241 females,45.82%;Meanage=13.29 years,SD=0.97 years)was recruited to complete the Negotiable Fate Belief Scale,Coping Self-Efficacy Scale,and the Positive and Negative Suicide Ideation Inventory-Negative Scale.We used structural equation modeling to test the mediation model and multigroup analysis to test the moderation effect of gender.Results:Negotiable fate belief is negatively correlated with suicidal ideation(r=-0.13,p<0.01).Moreover,coping self-efficacy mediates the relationship between negotiable fate belief and suicidal ideation(β=-0.06,95%confidence interval(CI)[-0.12,-0.02]),accounting for 35.29%of the total effect.Finally,the mediating effect of coping self-efficacy was found to be significant only for female left-behind children(male:95%CI[-0.09,0.07];female:95%CI[-0.16,-0.01]).For female left-behind children,the mediating effect was complete,with a coefficient of-0.06,accounting for 85.71%of the total effect.Conclusions:The relationship between negotiable fate belief and suicidal ideation among rural left-behind children is mediated by coping self-efficacy,and this mediation effect was moderated by gender.This study provides a theoretical explanation for how cultivating the belief in negotiable fate and coping self-efficacy is effective for reducing suicidal ideation of rural left-behind children.
基金supported by Clinical Research Operating Fund of Central High Level Hospitals(2022-PUMCH-B-088).
文摘Atopic dermatitis(AD)is one of the most common chronic inflammatory skin diseases.It usually develops in childhood and may persist into adulthood.Dupilumab is a fully human monoclonal antibody directed against interleukin-4R-alpha,the common chain of interleukin-4 and interleukin-13 receptors.Dupilumab showed clinical improvements in patients with atopic dermatitis,asthma,and chronic rhinosinusitis and is currently under development for other indications.However,there are many adverse effects reported after dupilumab therapy including local injection site reactions,conjunctivitis,headache,and nasopharyngitis.We report a new case of a 4-year-old child who experienced anaphylaxis after dupilumab injection.In addition to,we summary and disscuss the rare adverse reactions caused by dupilumab injection by searching the literature in pubmed.
文摘BACKGROUND Intra-arterial chemotherapy(IAC)has become a first-line standard treatment for retinoblastoma(RB).However,studies describing its adverse events are sparse,especially from the developing world.Our study described the outcomes and adverse events from a single center in South India.AIM To describe the challenges,treatment outcomes,and complications of selective IAC for RB in Indian eyes.METHODS This study was a single center,retrospective study that included 17 patients with RB who underwent IAC using melphalan(5/7.5 mg)and topotecan(1/2 mg)(n=12)or melphalan(5 mg)alone(n=3)or triple therapy that included carboplatin(30 mg)along with these drugs(n=2)between January 2018 and December 2023.In all,17 IAC procedures were performed using selective ophthalmic artery cannulation.Treatment outcomes were evaluated in terms of tumor control,vitreous and subretinal seed control,complications,and globe salvage rates.RESULTS Out of the 17 patients,11 were diagnosed with unilateral RB and 6 were diag-nosed with bilateral RB.The mean age at the time of diagnosis was 19.8 months.The mean interval between the first symptom and presentation was 6.5 months.IAC was employed as the primary(n=9)or secondary(n=8)modality of treatment.Each eye received a mean of 1.5 IAC sessions(median:1 session;range:1-3 sessions).Eyes were classified according to the international classification of RB as group B(n=5),group C(n=1),group D(n=4),and group E(n=7).Following IAC,complete regression of the main tumor was seen in 15 eyes(88%)and partial regression in 2 eyes(12%).Globe salvage was achieved in 15 eyes(88%).Adverse effects included vitreous hemorrhage(n=3),rhegmatogenous retinal de-tachment(n=2),choroidal ischemia(n=1),isolated subretinal hemorrhage(n=2),retinal pigment epithelium degeneration(n=2),forehead pigmentation(n=1),third nerve palsy with complete ptosis(n=1),and 30-degree exotropia(n=1).The mean follow-up period was 28.6 months(median:24 months,range:1–72 months).CONCLUSION IAC is an effective way to control RB and globe preservation.In the Indian context we encountered many cha-llenges highlighting the importance of case selection.Further studies in India are required to thoroughly un-derstand IAC as a treatment for RB.
文摘Objective:To explore the adverse reactions associated with antibiotics and analyze strategies for their rational use.Methods:A retrospective analysis was conducted on 60 patients who experienced adverse reactions to antibiotics between August 2021 and August 2023.The types of antibiotics that caused adverse reactions were analyzed,and the symptoms of adverse reactions and measures for rational use of antibiotics were summarized.Results:Among the analyzed cases of adverse reactions to antibiotics,the highest rate was observed in patients aged 61–75 years,accounting for 38.33%,followed by patients aged 51–60 years,accounting for 20.00%.In terms of the types of antibiotics that caused adverse reactions,cephalosporins were the most common,accounting for 40.00%,followed by penicillins,accounting for 18.33%.Analysis of the systems involved in adverse reactions showed that skin and appendage disorders were the most common,accounting for 36.67%,followed by the digestive system,accounting for 28.33%.Conclusion:Irrational use of antibiotics can lead to adverse drug reactions.Therefore,it is necessary to analyze strategies for the rational use of antibiotics to reduce adverse drug reactions and ensure the safety of antibiotic use.
基金Collaborative Innovation Program of Jiangsu Pharmaceutical Vocational College(Grant No.20239120)。
文摘The aim of this study is to evaluate the characteristics and patterns of adverse drug reactions(ADRs)associated with antineoplastic drugs and provide insights for safer chemotherapy practices.Based on 979 ADR cases reported in our hospital from January 1,2022,to December 31,2023,an analysis was conducted.Statistical analysis of the data revealed that 72.73%of these ADR incidents occurred in a hospital setting.The incidence of ADRs was higher in female patients compared to males,with the majority of cases(59.14%)observed in individuals aged 51-70 years.Intravenous administration was the predominant route linked to ADRs,accounting for 69.66%of the cases.Serious ADRs represented 9.30%of the total,including one instance where symptoms did not improve despite drug discontinuation or treatment.Cytotoxic antineoplastic drugs were responsible for 97.85%of all ADRs,with oxaliplatin being the most frequently implicated agent(19.82%).Gastrointestinal system involvement was the most common ADR manifestation,observed in 60.79%of cases.These findings underscored the necessity of enhanced monitoring for ADRs associated with cytotoxic antineoplastic drugs,particularly platinum-based agents.Comprehensive risk assessments and tailored treatment plans should be implemented during chemotherapy to minimize the occurrence of ADRs and safeguard patient safety.
基金supported by #NEXTGENERATIONEU(NGEU)and funded by the Ministry of University and Research(MUR),National Recovery and Resilience Plan(NRRP),project MNESYS(PE0000006)-(DN.155311.10.2022)supported by Sapienza Grant 2021(RM12117A60BDF685).
文摘Background Non-suicidal self-injury(NSSI)is a significant health concern among adolescents and young adults,often resulting from adverse childhood experiences(ACEs).Dissociation,post-traumatic symptoms and attachment style may have a role in shaping such associations.Aims This study aims to provide a unified model of the impact of ACEs on NSSI,exploring complex post-traumatic stress disorder(cPTSD)symptoms and dissociation as potential mediators and the role of the predominant attachment style in affecting such associations.Methods 1010 young individuals attending the last year of high school participated in this cross-sectional study.ACEs,cPTSD,dissociation and NSSI were evaluated using self-report questionnaires.We fitted a path model of NSSI,with ACEs as exogenous variables and cPTSD and dissociation as sequential mediators.Secure,fearful and preoccupied attachment styles were modelled as grouping variables.Results Our findings showed that dissociation mediated the impact of ACEs on NSSI in subjects with a fearful attachment style,as opposed to those with a preoccupied attachment for whom cPTSD symptoms mediated the ACEs-NSSI association.Conclusions Attachment styles moderate the relationship between ACEs and NSSI,with either dissociation or post-traumatic symptomatology mediating the impact of ACEs on NSSI,depending on the predominant attachment style.Our results highlight the importance of attachment as a pathway modifier in the relationships between different psychopathology dimensions,providing a useful framework to better conceptualise the ACEs-NSSI association.
基金Hubei Provincial Natural Science Foundation Innovation and Development Joint Fund Project(2025AFD278)Three Gorges University Scientific Fund Project(2022kj008)Three Gorges University Special Scientific Fund Project(2023kjzx001)。
文摘Objective:To utilize the VigiAccess database for data mining to analyze the characteristics of adverse reactions induced by mirogabalin,providing critical information for clinical medication use.Method:This study analyzed data from the VigiAccess database,filtering out adverse reaction reports where mirogabalin was identified as the Primary Suspect Drug(PS).Reporting Odds Ratio(ROR),Proportional Reporting Ratio(PRR),Bayesian Confidence Propagation Neural Network(BCPNN),and Empirical Bayes Geometric Mean(EBGM)methods were employed as data mining algorithms for pharmacovigilance and adverse event monitoring.These methods identify potential drug-adverse event association signals by analyzing the relationship between drug use and adverse event reporting.ROR and PRR focus on calculating reporting ratios,while BCPNN and EBGM use neural networks and empirical Bayes models,respectively,to enhance the accuracy and reliability of signal detection.Results:A total of 734 adverse reaction reports associated with mirogabalin were obtained.The results showed that females reported the highest number of adverse reactions,accounting for 59.67%,while males accounted for 38.83%.In terms of age distribution,the highest number of reports came from individuals over 75 years old,accounting for 33.79%.Adverse reactions mainly involved the nervous system(33.45%),general diseases and reactions at the site of administration(11.62%),and gastrointestinal disorders(10.74%).The most common adverse reactions included dizziness(11.62%),somnolence(8.27%),renal dysfunction(2.90%),and edema(2.82%).Signal intensity analysis revealed that certain adverse reactions(such as renal dysfunction,rhabdomyolysis,and drug-induced liver injury)had significant signal strength,suggesting a strong association with mirogabalin.Conclusion:This study,through signal mining of the VigiAccess database,reveals the characteristics of mirogabalin’s adverse reactions in the real world,particularly in the nervous system and renal function.These findings provide important reference information for clinicians,aiding in the optimization of the safe use of mirogabalin.Future research should further validate the causal relationships of these signals and explore individualized treatment strategies to reduce the incidence of adverse reactions and improve patient outcomes.
文摘Monitoring adverse drug reactions(ADRs)in primary medical institutions is crucial to ensuring medication safety.Currently,this work faces difficulties such as insufficient professional ability of staff,imperfect monitoring systems,and low patient awareness.It is necessary to improve the level of ADR monitoring at the grassroots level and ensure the safety and effectiveness of medication through countermeasures such as strengthening personnel training,optimizing monitoring processes,and raising public awareness.
文摘Obesity is a global pandemic that has been threatening the worldwide population.It has been reported to be associated with an increase in the risk of chronic diseases such as type 2 diabetes mellitus(T2DM),cardiovascular disease,and other diseases,including some malignancies.Currently,the first line of management includes lifestyle modifications.However,recently,bariatric surgeries were introduced to combat obesity.The previous modalities of management are always challenging since lifestyle could have limited long-term effectiveness and difficulty to achieve,and surgeries are invasive and also require a lifestyle modification and commitment.Glucagon-like peptide-1 receptor agonists(GLP-1RAs)were initially introduced as a rising star for managing T2DM,with patients benefiting from the control of blood sugar and weight loss.These medications work by enhancing feelings of fullness,slowing down digestion,and ultimately reducing calorie intake.However,GLP-1RAs are not without side effects and have some costs.Common side effects include gastrointestinal(GI)adverse events such as nausea,vomiting,diarrhea,and a lack of GI motility,which is the main mechanism through which the drug induces a feeling of fullness and promotes weight loss,potentially resulting in treatment discontinuation.More serious,though less frequent,risks include pancreatitis,gallbladder diseases,and,rarely,thyroid Ccell cancers.This review aimed to discuss the globally emerging role of GLP-1RAs in obesity management and highlight some safety considerations for patients taking these drugs.
基金supported by the National Natural Science Foundation of China(No.82273711).
文摘Existing evidence has demonstrated the association between exposure to volatile organic compounds(VOCs)and osteoporosis(OP)risk,but the underlying mechanistic framework remains unclear.This study aimed to explore potential pathways using adverse outcome pathway(AOP)analysis,and evidence this association in middle-to-old-aged American adults using the updated National Health and Nutrition Examination Survey data.Multivariable-adjusted general linear and weighted quantile sum models were employed to analyze associations of VOC metabolites(VOCMs),representing internal VOCs exposure levels,with OP-related phenotypes.An AOP framework based on network analysis was developed by extracting target genes and phenotypes.Among 3555 American adults aged≥40 years(539 OP participants),we found that increasing urinary 3-and 4-methylhippuric acid,N-acetyl-S-(n-propyl)-l-cysteine(BPMA),and N-acetyl-S-(3-hydroxypropyl)-l-cysteine were associated with elevated OP odds with odds ratios(ORs)(95%confidence intervals,95%CIs)being 1.254(1.016 to 1.548),1.182(1.014 to 1.377),and 1.244(1.029 to 1.505),respectively,per standard deviation.Urinary BPMA and N-acetyl-S-(2-cyanoethyl)-l-cysteine were inversely associated with lumbar spine bone mineral density(BMD),while urinary N-acetyl-S-(2-hydroxypropyl)-l-cysteine was positively associated with hip BMD.Additionally,OP odds increased by 46.0%(95%CI:3.9%to 105.1%)per quartile increment in the VOC mixture.AOP analysis identified 53 target genes and 9 target phenotypes,and 5 of 9 target phenotypes were oxidative stress(OS)-related.Literature and the“AOP 482”framework implied the core role of OS in the VOC exposure and prevalent OP association,with the interleukin-6 as themolecular initiating event.Our findings provided a theoretical basis for further investigation.
文摘BACKGROUND In randomized controlled trials(RCTs),the placebo arm has often been ignored as the attention tends to be focused on the treatment arm.We undertook a meta-analysis based on the data from the placebo arm in RCTs of hepatocellular carci-noma(HCC),the response rates and survival status,and adverse events(AEs)were summarized and evaluated.AIM To systematically evaluate the response rates,survival status and AEs in the placebo arms of RCTs for HCC.METHODS A systematic search was performed on PubMed,Ovid MEDLINE,Embase and Cochrane Library to identify relevant trials evaluating the efficacy of drugs for the treatment of HCC,published until December 31,2023.Statistical analysis was performed using R statistical software(version 4.3.2).RESULTS A total of 18 RCTs,involving 2390 patients,met the criteria for inclusion in the meta-analysis.The pooled overall disease control rate and objective response rate in the placebo group were 38%[95%confidence interval(CI):33%-42%]and 1%(95%CI:1%-2%),respectively.Overall survival and progression-free survival in the placebo group were 7.9 months(95%CI:7.6-8.31 months)and 1.9 months(95%CI:1.6-2.1 months),respectively.The incidence of grade 3 or 4 AEs was 37%(95%CI:30%-43%).Additionally,the incidence of interruptions or dose reductions due to AEs was 20%(95%CI:13%-27%),while the incidence of treatment discontinuation due to AEs was 9%(95%CI:6%-12%).CONCLUSION Over one-third of advanced HCC patients exhibit therapy-free disease control,with placebo-arm AEs observed.These findings guide single-arm trials design and enhance patient acceptance of anticancer therapies.
基金the support from the National Natural Science Foundation of China(Nos.52279103,52379103)the Natural Science Foundation of Shandong Province(No.ZR2023YQ049)。
文摘Geological analysis,despite being a long-term method for identifying adverse geology in tunnels,has significant limitations due to its reliance on empirical analysis.The quantitative aspects of geochemical anomalies associated with adverse geology provide a novel strategy for addressing these limitations.However,statistical methods for identifying geochemical anomalies are insufficient for tunnel engineering.In contrast,data mining techniques such as machine learning have demonstrated greater efficacy when applied to geological data.Herein,a method for identifying adverse geology using machine learning of geochemical anomalies is proposed.The method was identified geochemical anomalies in tunnel that were not identified by statistical methods.We by employing robust factor analysis and self-organizing maps to reduce the dimensionality of geochemical data and extract the anomaly elements combination(AEC).Using the AEC sample data,we trained an isolation forest model to identify the multi-element anomalies,successfully.We analyzed the adverse geological features based the multi-element anomalies.This study,therefore,extends the traditional approach of geological analysis in tunnels and demonstrates that machine learning is an effective tool for intelligent geological analysis.Correspondingly,the research offers new insights regarding the adverse geology and the prevention of hazards during the construction of tunnels and underground engineering projects.
