Objective:Research suggests that caregivers of children with asthma experience a substantial amount of stress,though no comprehensive study examines this problem.Here we both quantitatively and qualitatively examined ...Objective:Research suggests that caregivers of children with asthma experience a substantial amount of stress,though no comprehensive study examines this problem.Here we both quantitatively and qualitatively examined the burden on caregivers of children with asthma.Methods:Surveys were administered to 138 caregivers of asthmatic children by convenience sampling.The Zarit Caregiver Burden Interview(ZBI)was used to assess the degree of caregiver burden.In addition,13 qualitative semi-structured interviews were carried out via purposive sampling and were used to explore the perception of caregivers.SPSS and content analysis were used to analyze quantitative and qualitative data,respectively.Results:We found that caregiver burden(mean=31.56±14.19)ranged from 24%with no or mild burden,52%with mild to moderate burden,22%with moderate to severe burden and 2%with very severe burden.Caregiver burden was also assessed as 5 different dimensions.Selfcriticism ranked most burdensome(2.09±1.05),followed by sacrifice(1.57±0.94),embarrassment/anger(1.30±0.80),dependency(1.21±0.77),and lastly,loss of control(1.20±0.84).The highest individually scored item on the ZBI was“fear of the future of the relative”(mean=3.04).Interviews of caregiver burden were summarized into three main themes,namely:1)life is too chaotic;2)negative emotions;and 3)gaps in themedical support system.Conclusions:These findings expand our understanding about the burden caregivers of children with asthma face,and may help to propose targeted strategies to help caregivers adapt to their roles,and maintain and promote the health of themselves and their families.展开更多
Background Clonorchiasis is an important foodborne parasitic disease in China caused by Clonorchis sinensis.Accurate and rapid diagnosis of this disease is vital for treatment and control.Traditional fecal examination...Background Clonorchiasis is an important foodborne parasitic disease in China caused by Clonorchis sinensis.Accurate and rapid diagnosis of this disease is vital for treatment and control.Traditional fecal examination methods,such as the Kato-Katz(KK)method,are labor-intensive,time-consuming,and have limited acceptance.The FA280,an advanced automated fecal analyzer,increases efficiency while significantly reducing labor load.This study aims to evaluate its performance,applicability,and scalability in clonorchiasis diagnosis to explore its potential application in the future.Methods A mixed-methods study integrating both quantitative and qualitative approaches was conducted.The quantitative component consisted of a cross-sectional survey in Xinhui District,Guangdong,China,to evaluate the diagnostic performance of the FA280.The positive rate and agreement between the FA280 and the KK method were evaluated using McNemar’s test.Additionally,Pearson’s Chi-square test was used to analyze the consistency of positive results between the two methods across various eggs per gram(EPG)groups under different cut-off values.The qualitative component included semi-structured individual interviews with medical staff and institutional administrators to examine the FA280’s applicability and potential for broader adoption,with thematic analysis of the data.Results In the quantitative study of 1000 participants,both the FA280 and KK methods detected clonorchiasis with a positive rate of 10.0%,achieving 96.8%agreement and showing no significant difference(P>0.999).The kappa value was 0.82(95%confidence interval:0.76-0.88),indicating a strong agreement between the methods.The agreement rate for positive results between the two methods was significantly higher in the high infection intensity group compared to the low infection intensity group(P<0.05).The qualitative study,which involved interviews with three medical staff and two administrators revealed that the FA280 outperformed the KK method in testing procedures,detection results,and user acceptance.The benefits,challenges,and suggestions of FA280 promotion were also emphasized.Conclusions This study demonstrated the FA280’s application value in clonorchiasis diagnosis by assessing its detection performance,applicability,and scalability.These findings contribute to the future prevention and control of the disease.展开更多
Objective:To investigate the dynamic trajectory,predictors,and underlying adaptation mechanisms of family resilience(FR)among Chinese families with preterm infants(PIs)from birth to six months.Methods:Guided by Ecolog...Objective:To investigate the dynamic trajectory,predictors,and underlying adaptation mechanisms of family resilience(FR)among Chinese families with preterm infants(PIs)from birth to six months.Methods:Guided by Ecological Systems Theory,a convergent parallel mixed-methods study was conducted in the Neonatal Intensive Care Unit(NICU)of a tertiary hospital in Fujian Province,China,from June 2023 to June 2024.Quantitative data were collected from 202 caregivers selected by convenience sampling at four time points:at birth(T0),42 days postpartum(T1),3 months postpartum(T2),and 6 months postpartum(T3).Generalized Estimating Equations(GEE)was used to analyze scale score differences across time points and explore factors influencing FR.Qualitative data were collected through semi-structured interviews with 14 caregivers recruited by maximum variation purposive sampling and analyzed using Colaizzi’s phenomenological approach.After conducting separate data analyses,the findings were integrated through side-by-side comparison and joint display.Results:Quantitative results revealed a non-linear,“V”-shaped trajectory of FR,significantly influenced by educational level,conception via assisted reproduction,farming occupation,coping style,psychological resilience,family functioning,and social support.Qualitative findings identified four themes:initial uncertainty and emotional distress,post-discharge anxiety,gradual adaptation,and eventual stabilization.Integrated mixed-methods findings revealed that the initial confusion phase demands a comprehensive response to family needs(T0);the post-discharge bottleneck requires addressing the care capability-needs gap(T1);the role adaptation phase is pivotal for enhancing internal family resources(T2);and the family-work transition necessitates enhanced work-family facilitation(T3).Conclusions:This study systematically identifies the unique“V”-shaped trajectory of FR in Chinese families with PIs and its key influencing factors,and accurately analyzes their dynamic experiences and adaptation across four stages.These findings provide an empirical basis for stage-specific targeted interventions,strongly support the practical advancement of the family-centered care model,and deliver critical guidance for enhancing FR.展开更多
This study explores the influence of after-school tutoring on reading comprehension skills of students with dyslexia(DD)in grades 3-5 in China and its participating factors.Using a mixed-methods design,the quantitativ...This study explores the influence of after-school tutoring on reading comprehension skills of students with dyslexia(DD)in grades 3-5 in China and its participating factors.Using a mixed-methods design,the quantitative data(GORT-4 reading test)of 50 public primary school students in Qingdao and their parents’feedback were collected through questionnaires,supplemented by semi-structured interviews with eight parents for qualitative analysis.The findings are as follows:(1)Family socioeconomic status and parents’awareness of DD are the key factors to participate in after-school counseling;(2)The students who participated in the after-school counseling performed significantly better in the GORT-4 comprehension test(P<0.05);(3)Counseling makes up for the lack of classroom learning through personalized strategies(such as multi-sensory teaching and phonological awareness training),but parents’psychological support is the core of successful intervention.The necessity of early targeted intervention was emphasized,and practical enlightenment was provided for the educational support system of DD students in China.展开更多
Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsist...Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.展开更多
This paper proposes an interdisciplinary talent training model that combines foreign language education with area studies.The model aims to cultivate international ocean affairs professionals with cross-cultural commu...This paper proposes an interdisciplinary talent training model that combines foreign language education with area studies.The model aims to cultivate international ocean affairs professionals with cross-cultural communication skills,in-depth regional and country knowledge,and practical expertise in ocean affairs.Additionally,the paper presents specific training pathways and policy recommendations for implementing this model.展开更多
In modern society,the globalization of literary works is evident,with exceptional literary pieces from various countries spreading worldwide.Among these,children’s literature,due to the specificity of its target audi...In modern society,the globalization of literary works is evident,with exceptional literary pieces from various countries spreading worldwide.Among these,children’s literature,due to the specificity of its target audience,imposes distinct requirements on children’s books,compelling translators to approach the text from a child’s perspective.“The Little Prince”has renowned both within and outside of China,and a careful reading of this work can provide us with much inspiration.To this end,the present study adopts the perspective of Gideon Toury’s Descriptive Translation Studies to conduct an in-depth analysis of the different English and Chinese translations in conjunction with the original French novel.This approach aims to better guide literary research and explores translation methods for children’s literature through the analysis of translation norms and rules.展开更多
Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth...Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth interviews with patients and families,anchored by Interactive Patient Par ticipation Theory,to analyze 4 high-severity adverse drug events(ADE)cases.Cases were purposively sampled from 8 communities in China's National Adverse Event Monitor Center(2018-2023).Semi-structured interviews explored patient perspectives,with data analyzed via thematic coding and triangulation against clinical records.Results:Five interconnected themes emerged:(1)erosion of trust,(2)communication breakdowns,(3)information asymmetry,(4)environmental inadequacies,and(5)technological alienation.Notably,75% of participants had≤high school education,and 50% used≥7 medications daily,compounding ADE risks.Conclusions:We considered elements mentioned by theory,exploring trust,communication,information,and suppor t as the root causes.In addition,we added“adaptability to new technology”as an impor tant and necessary component.It is impor tant and necessary to analyze typical adverse drug events from the perspectives of patients.展开更多
China ranked first worldwide in the production and export of electric bicycles.As an emerging market for electric bicycles,Malaysia holds significant potential for trade collabor ation with China in this sector.This s...China ranked first worldwide in the production and export of electric bicycles.As an emerging market for electric bicycles,Malaysia holds significant potential for trade collabor ation with China in this sector.This study presents a compar ative analysis of the national electric bicycle standards in China and Malaysia,offering technical insights from a standardization perspective.These insights aim to support Chinese enterprises in strategically positioning their technologies in the Malaysian market.The findings reveal significant differences in technical parameters,safety requirements,and testing methods,highlighting the need for tailored product adapt ation.展开更多
This paper investigates the teaching reform of the Program Comprehension and Analysis course in the context of industry-education integration and AI empowerment.To align with the evolving needs of the software industr...This paper investigates the teaching reform of the Program Comprehension and Analysis course in the context of industry-education integration and AI empowerment.To align with the evolving needs of the software industry,the course content has been updated to incorporate AI techniques such as large language models and deep learning.The reform enriches educational resources and introduces innovative instructional approaches.In addition,high-quality practical teaching cases have been developed,and immersive,hands-on learning experiences have been designed based on industrial platforms and real-world applications.These initiatives aim to enhance the practical skills and innovative thinking of professional degree graduate students,fostering high-caliber talent that aligns with industry demands.A survey of 90 graduate students revealed high levels of satisfaction regarding course content,teaching methodology,and skill development.The reform has proven effective in cultivating interdisciplinary professionals with solid foundations in software engineering and AI-driven innovation.展开更多
Mindfulness would enhance university students’emotional well-being and study engagement.However,the role of affect(positive and negative emotions)and psychological resources(psychological capital)linking mindfulness ...Mindfulness would enhance university students’emotional well-being and study engagement.However,the role of affect(positive and negative emotions)and psychological resources(psychological capital)linking mindfulness to study engagement remain underexplored.This cross-sectional study surveyed 688 Chinese university students(females=413,mean age=20.3,SD=0.83),using validated self-report measures of mindfulness,positive and negative emotions,psychological capital,and study engagement.Structural equation modeling and bias-corrected bootstrap analyses(5000 resamples)revealed that mindfulness directly enhanced positive emotions,psychological capital,and study engagement,while reducing negative emotions.Positive emotions partially mediated the positive effect of mindfulness on psychological capital and study engagement.Negative emotions partially and negatively mediated only the mindfulness-psychological capital link.Psychological capital independently mediated the mindfulness-engagement relationship,and two sequential mediation pathways emerged:(a)mindfulness→positive emotions→psychological capital→higher study engagement and(b)mindfulness→reduced negative emotions→psychological capital→higher study engagement.Consistent with broaden-and-build(B&B)theory and Conservation of Resources(COR)theory,these findings suggest that mindfulness fosters study engagement primarily by promoting positive emotional experiences and strengthening psychological capital.By implication,university student support programs should employ mindfulness-based interventions to cultivate emotional and psychological resources for higher students’engagement and overall well-being.展开更多
BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as exp...BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as expanding treatment indications,which affect the fair distribution of medical resources.There is limited research on ethical issues in the field of digestive endoscopy.AIM To investigate the level of ethical awareness among gastrointestinal endoscopy practitioners and analyze the ethical issues involved in gastrointestinal endoscopy technology.METHODS A questionnaire survey was performed to collect relevant data(gender,age,degree of education,professional title,personnel category,the level of understanding medical ethical principles,ethics training and its learning pathways)from gastrointestinal endoscopy practitioners at the Second Hospital of Dalian Medical University and Dalian Friendship Hospital,including licensed physicians and nurses(including trainees and graduate students).RESULTS The majority of gastrointestinal endoscopy practitioners have received training on ethics,but there is still considerable room for improvement in their ethical awareness.Different learning pathways may affect the mastery of ethical principles, and understanding of ethical principles is more easily achieved through hospital ethics institutions.CONCLUSIONTo address the ethical issues in gastrointestinal endoscopy technology, it is necessary to enhance the humanisticeducation of gastrointestinal endoscopy practitioners, incorporate ethical standards into the technology assessmentprocess, and establish a patient-centered diagnostic and treatment model to improve the ethical awareness of practitionersand achieve a balance between technology and ethics.展开更多
Escalating global energy demands and climate urgency necessitate advanced electrochemical energy conversion and storage technologies(EECSTs)like electrocatalysis and rechargeable batteries.Improving their performance ...Escalating global energy demands and climate urgency necessitate advanced electrochemical energy conversion and storage technologies(EECSTs)like electrocatalysis and rechargeable batteries.Improving their performance relies on elucidating reaction mechanisms and structure-performance relationships via in situ studies.This review summarizes recent in situ studies of EECSTs through a variety of advanced characterization techniques aiming at mapping reaction pathways for the rational design of overall high-performance reaction systems.We outline the principles,capabilities,advantages,and limitations of various in situ techniques.Their applications in in situ studies of fuel cells,water/CO_(2)electrolysis,and lithium batteries are highlighted with representative examples.These studies enable dynamic tracking of chemical and structural evolution of overall reaction systems,including materials,intermediates,products,and surroundings during operation,providing insights critical to rational system design.Future advancements will involve integrating multimodal in situ/operando approaches with artificial intelligence to enable real-time monitoring at practical scales.Such integration promises precise mechanistic insights and robust structure-performance correlations,ultimately accelerating the development of high-performance EECSTs aligned with sustainability and market requirements.展开更多
Objectives:In recent years,mental health has emerged as a pressing public health concern in China,driven by mounting societal pressures and fast-paced urban lifestyles.Physical activity,a well-established means of enh...Objectives:In recent years,mental health has emerged as a pressing public health concern in China,driven by mounting societal pressures and fast-paced urban lifestyles.Physical activity,a well-established means of enhancing psychological well-being,has received growing scholarly and policy attention.This study uses panel data from the 2020 and 2022 waves of the China Family Panel Studies(CFPS)to examine the impact of exercise frequency on mental health(with indicators such as CESD-8 depression scores)among college students and young employees,thereby providing empirical support for targeted mental health interventions.Methods:This study examines the relationship between individual exercise frequency and mental health among college students and young employees,using panel data from the 2020 and 2022 waves of the China Family Panel Studies(CFPS),with the Chinese version of the 8-item Center for Epidemiologic Studies Depression Scale(CESD-8)depression scores,self-rated health,and life satisfaction as outcome variables.Specifically,this study tests three hypotheses:(H1)increased exercise frequency significantly reduces depression symptoms and enhances well-being;(H2)the effects of exercise vary by social roles,with stronger mental health benefits among employed individuals and those with lower education;and(H3)lifestyle factors such as smoking amount,sleep duration,and Body Mass Index(BMI)partially mediate the relationship between exercise and mental health.Employing a two-way fixed effects model,baseline results indicate that a one-unit increase in exercise frequency significantly reduces the CESD-8 score by 0.183 points.To address potential endogeneity and spurious regression concerns,an instrumental variable(IV)approach is further applied.The heterogeneity analysis differentiates between students and employed individuals.Results:Among students,the effects of exercise on mental health are not statistically significant,regardless of education level.In contrast,for the employed,exercise demonstrates a significant positive impact on mental health,with particularly pronounced effects among those with lower educational attainment.These findings underscore the importance of promoting exercise as part of comprehensive mental health strategies.Mediation analysis indicates that the beneficial effect of exercise on mental health is partially transmitted through reductions in adverse health behaviors,especially smoking.Conclusions:Policymakers should integrate physical activity promotion into health interventions,prioritizing vulnerable groups to enhance psychological resilience and foster inclusive,health-oriented development.展开更多
AIM:To investigate the potential causal associations between 41 inflammatory cytokines and myopia using a two-sample Mendelian randomization(MR)approach.METHODS:Publicly available genome-wide association study(GWAS)da...AIM:To investigate the potential causal associations between 41 inflammatory cytokines and myopia using a two-sample Mendelian randomization(MR)approach.METHODS:Publicly available genome-wide association study(GWAS)datasets were utilized for this two-sample MR analysis.Inflammatory cytokine-related GWAS data were extracted from The University of Bristol’s Research Data Repository,and myopia-related GWAS data were obtained from the FinnGen project.Single nucleotide polymorphisms(SNPs)associated with inflammatory cytokines were systematically selected as instrumental variables(IVs)based on three rigorous criteria:relevance,independence,and exclusion of pleiotropy.Five MR methods were employed for causal inference:the inverse-variance weighted(IVW)method as the primary analysis,supplemented by MREgger regression,weighted median estimator,simple mode,and weighted mode approaches.Sensitivity analyses were performed to evaluate the robustness of the causal estimates.RESULTS:A total of 773 myopia-associated SNPs were identified.MR analysis revealed that higher levels of macrophage inflammatory protein 1-α(MIP-1α)were associated with a 17%reduced risk of myopia[odds ratio(OR)=0.83;95%confidence interval(CI):0.69-0.99;P<0.05].In contrast,elevated levels of eotaxin(OR=1.26;95%CI:1.07-1.47;P<0.01),stromal cell-derived factor-1α(SDF-1α;OR=1.68;95%CI:1.08-2.62;P<0.05),and interleukin-2 receptor subunit alpha(IL-2Rα;OR=1.25;95%CI:1.01-1.53;P<0.05)were significantly associated with an increased risk of myopia.Sensitivity analyses confirmed the reliability of these results.CONCLUSION:This study provides evidence supporting a causal relationship between specific inflammatory cytokines and myopia.MIP-1αmay act as a protective factor against myopia,while eotaxin,SDF-1α,and IL-2Rαare potential risk factors for myopia.These findings emphasize the critical role of inflammatory pathways in the pathogenesis of myopia,offering novel insights for the development of preventive and therapeutic strategies for myopia.展开更多
Objective Patients with atherosclerotic cardiovascular disease(ASCVD)following percutaneous coronary intervention(PCI)are classified as very-high-risk individuals in cardiovascular disease(CVD)risk stratification.The ...Objective Patients with atherosclerotic cardiovascular disease(ASCVD)following percutaneous coronary intervention(PCI)are classified as very-high-risk individuals in cardiovascular disease(CVD)risk stratification.The distribution pattern of traditional Chinese medicine(TCM)syndromes in this patient population,as well as its association with blood lipid profiles and clinical prognosis,remains unclear.The present prospective cohort study aims to investigate these correlations,thereby providing insights to enrich the research fields.Methods We enrolled consecutive patients with ASCVD who underwent PCI at the Integrated Cardiology Unit of China-Japan Friendship Hospital between September 1,2020 and December 31,2022.Demographics and clinical characteristics,signs and symptoms defining each TCM syndrome,and fasting venous blood samples were collected at baseline and follow up or upon major adverse cardiovascular events(MACEs).We analyzed the correlation between TCM syndromes,blood lipid profiles,and MACEs,and developed a new joint prognostic model incorporating both TCM syndromes and blood lipids using logistic regression.The analyses were based on detailed baseline and one-year follow-up data.Results A per-protocol analysis was performed on 586 patients with complete data ultimately.During the one-year follow-up,174 patients(29.69%)experienced a MACE.We performed statistical analyses on comorbidities,medication,and biochemical indicators across groups defined by TCM syndrome differentiation.When comparing different TCM syndromes,no significant differences were found in age,body mass index(BMI),history of revascularization,comorbidities,family history of CVD,smoking or drinking,or statin intensity(P>0.05).Patients with intertwined phlegm and blood stasis syndrome exhibited significantly higher levels of total cholesterol(TC,5.27±1.18 mmol/L,P<0.001),triglyceride(TG,1.96±1.33 mmol/L,P=0.008),low-density lipoprotein cholesterol(LDL-C,3.35±0.79 mmol/L,P<0.001),and high-density lipoprotein cholesterol(HDL-C,1.24±0.81 mmol/L,P<0.001)compared with those with other TCM syndromes combined.A multivariable logistic regression model was constructed to predict MACEs.The model included TCM syndrome type[with intertwined phlegm and blood stasis as a predictor,adjusted odds ratio(OR)=1.413,95%confidence interval(CI):0.517–3.864,P=0.501],age(adjusted OR=0.97,95%CI:0.955–1.001,P=0.057),male gender(adjusted OR=0.698,95%CI:0.416–1.170,P=0.173),TC(adjusted OR=1.004,95%CI:0.513–1.965,P=0.990),and LDL-C(adjusted OR=5.825,95%CI:2.214–15.326,P<0.001).This model demonstrated good discriminatory ability for MACEs in post-PCI ASCVD patients[the area under the receiver operating characteristic(ROC)curve(AUC)=0.865,95%CI:0.816–0.914].Conclusion The intertwined phlegm and blood stasis TCM syndrome is associated with a distinct atherogenic lipid profile characterized by elevated levels of TC and LDL-C.The prognostic model that incorporates this TCM syndrome type along with conventional lipid parameters(TC and LDL-C)shows good discriminatory ability for predicting MACEs in ASCVD patients after PCI,underscoring the potential clinical utility of integrating TCM syndrome differentiation into CVD risk assessment.展开更多
Objective:To analyze factors affecting the utilization of human immunodeficiency virus counseling and testing(HCT)service among human immunodeficiency virus risk groups at Hessa Air Genting Health Center,Asahan Regenc...Objective:To analyze factors affecting the utilization of human immunodeficiency virus counseling and testing(HCT)service among human immunodeficiency virus risk groups at Hessa Air Genting Health Center,Asahan Regency,North Sumatera,Indonesia.Methods:This quantitative unmatched case-control study was conducted from April 2024 to April 2025 at Hessa Air Genting Health Center,Asahan Regency,North Sumatra Province,Indonesia.Female sex workers and men who have sex with men were selected using purposive sampling based on predefined inclusion and exclusion criteria.Data were collected via questionnaires and analyzed using SPSS version 18.0,with univariate analysis,bivariate analysis(Chi-square test),and multivariate analysis(logistic regression analysis).Results:Comprehensive analysis of 75 cases and 75 controls was conducted to identify factors affecting the utilization of HCT services.Specifically,this study identified significant effects of knowledge(OR 3.2,95%CI 1.5-7.0,P=0.003),perception(OR 5.6,95%CI 2.5-12.5,P<0.001),information media(OR 3.1,95%CI 1.4-6.8,P=0.005),and health workers encouragement(OR 4.0,95%CI 1.5-10.4,P=0.005).In contrast,access to health services did not have a significant effect.Conclusions:Knowledge,perception,information media,and health worker encouragement had significant effects on HCT service utilization,with perception identified as the dominant factor.To improve utilization,strengthening positive perceptions,targeted training for healthcare workers,strengthened partnerships with local non-governmental organizations,and the use of social media for health promotion are recommended.展开更多
Existing evidence suggests residential greenness is beneficial to human,while no research to date explored the associations of greenness with age-related macular degeneration(AMD).To evaluate the association of greenn...Existing evidence suggests residential greenness is beneficial to human,while no research to date explored the associations of greenness with age-related macular degeneration(AMD).To evaluate the association of greenness with AMD,modification and mediation effect of air pollution,we conducted this prospective study.We con-structed weighted quantile sum(WQS)index as co-exposure to nitrogen oxides(NO_(x)),particulate matter<2.5μm(PM_(2.5)),particulate matter<10μm(PM10).Stratified Cox regression models were applied to test the effect of exposure.Effect modification of air pollution was assessed.Stratified Cox models through the indirect method and Aalen additive risk models were used in mediation analysis.Over median follow-up of 11.67 years,4596 AMD events were ascertained.Hazard ratios(HRs)and 95%confidence intervals(95%CIs)of incident AMD for pollution per interquartile range(IQR)increment were 1.10(1.04–1.16)for nitrogen dioxide(NO_(2)),1.09(1.03–1.15)for NO_(x),1.14(1.05–1.24)for PM_(2.5),1.13(1.05–1.21)for PM10.The HR(95%CI)of AMD associated with greenness 1000 m buffer per IQR increment was 0.91(0.86–0.97),300 m buffer was 0.94(0.89–0.99).The as-sociation between greenness 1000 m and AMD was 28.59%,44.77%,35.59%,32.31%and 27.08%mediated by the decreased WQS index,NO_(2),NO_(x),PM_(2.5) and PM10,respectively.Increased greenness was associated with lower AMD incidence,and air pollution partly mediate it,which implies that interventions aimed at improving air quality and increasing greenness could have a dual benefit in mitigating AMD risk.展开更多
Background:Despite highly effective vaccines against SARS-CoV-2,COVID-19 vaccine hesitancy persisted in some populations in England during the pandemic,with rates and motivations for hesitancy varying by demographic g...Background:Despite highly effective vaccines against SARS-CoV-2,COVID-19 vaccine hesitancy persisted in some populations in England during the pandemic,with rates and motivations for hesitancy varying by demographic group.Addressing the drivers of vaccine hesitancy through targeted interventions in hesitant groups is a public health priority for better and more rapid control of disease spread.We aimed to characterise the determinants and subtypes of vaccine hesitancy and identify more persistent forms of hesitancy via analysis of vaccine uptake in a large cross-sectional cohort with linked National Health Service(NHS)data.展开更多
基金Funding was provided for this manuscript:We receive the fund of Science and technology department of Guangdong province,NO.2014A020212366.
文摘Objective:Research suggests that caregivers of children with asthma experience a substantial amount of stress,though no comprehensive study examines this problem.Here we both quantitatively and qualitatively examined the burden on caregivers of children with asthma.Methods:Surveys were administered to 138 caregivers of asthmatic children by convenience sampling.The Zarit Caregiver Burden Interview(ZBI)was used to assess the degree of caregiver burden.In addition,13 qualitative semi-structured interviews were carried out via purposive sampling and were used to explore the perception of caregivers.SPSS and content analysis were used to analyze quantitative and qualitative data,respectively.Results:We found that caregiver burden(mean=31.56±14.19)ranged from 24%with no or mild burden,52%with mild to moderate burden,22%with moderate to severe burden and 2%with very severe burden.Caregiver burden was also assessed as 5 different dimensions.Selfcriticism ranked most burdensome(2.09±1.05),followed by sacrifice(1.57±0.94),embarrassment/anger(1.30±0.80),dependency(1.21±0.77),and lastly,loss of control(1.20±0.84).The highest individually scored item on the ZBI was“fear of the future of the relative”(mean=3.04).Interviews of caregiver burden were summarized into three main themes,namely:1)life is too chaotic;2)negative emotions;and 3)gaps in themedical support system.Conclusions:These findings expand our understanding about the burden caregivers of children with asthma face,and may help to propose targeted strategies to help caregivers adapt to their roles,and maintain and promote the health of themselves and their families.
基金supported by the Natural Science Foundation of Guangdong Province(Grant No.2022A1515010042)the National Natural Science Foundation of China(Grant No.82073665).
文摘Background Clonorchiasis is an important foodborne parasitic disease in China caused by Clonorchis sinensis.Accurate and rapid diagnosis of this disease is vital for treatment and control.Traditional fecal examination methods,such as the Kato-Katz(KK)method,are labor-intensive,time-consuming,and have limited acceptance.The FA280,an advanced automated fecal analyzer,increases efficiency while significantly reducing labor load.This study aims to evaluate its performance,applicability,and scalability in clonorchiasis diagnosis to explore its potential application in the future.Methods A mixed-methods study integrating both quantitative and qualitative approaches was conducted.The quantitative component consisted of a cross-sectional survey in Xinhui District,Guangdong,China,to evaluate the diagnostic performance of the FA280.The positive rate and agreement between the FA280 and the KK method were evaluated using McNemar’s test.Additionally,Pearson’s Chi-square test was used to analyze the consistency of positive results between the two methods across various eggs per gram(EPG)groups under different cut-off values.The qualitative component included semi-structured individual interviews with medical staff and institutional administrators to examine the FA280’s applicability and potential for broader adoption,with thematic analysis of the data.Results In the quantitative study of 1000 participants,both the FA280 and KK methods detected clonorchiasis with a positive rate of 10.0%,achieving 96.8%agreement and showing no significant difference(P>0.999).The kappa value was 0.82(95%confidence interval:0.76-0.88),indicating a strong agreement between the methods.The agreement rate for positive results between the two methods was significantly higher in the high infection intensity group compared to the low infection intensity group(P<0.05).The qualitative study,which involved interviews with three medical staff and two administrators revealed that the FA280 outperformed the KK method in testing procedures,detection results,and user acceptance.The benefits,challenges,and suggestions of FA280 promotion were also emphasized.Conclusions This study demonstrated the FA280’s application value in clonorchiasis diagnosis by assessing its detection performance,applicability,and scalability.These findings contribute to the future prevention and control of the disease.
文摘Objective:To investigate the dynamic trajectory,predictors,and underlying adaptation mechanisms of family resilience(FR)among Chinese families with preterm infants(PIs)from birth to six months.Methods:Guided by Ecological Systems Theory,a convergent parallel mixed-methods study was conducted in the Neonatal Intensive Care Unit(NICU)of a tertiary hospital in Fujian Province,China,from June 2023 to June 2024.Quantitative data were collected from 202 caregivers selected by convenience sampling at four time points:at birth(T0),42 days postpartum(T1),3 months postpartum(T2),and 6 months postpartum(T3).Generalized Estimating Equations(GEE)was used to analyze scale score differences across time points and explore factors influencing FR.Qualitative data were collected through semi-structured interviews with 14 caregivers recruited by maximum variation purposive sampling and analyzed using Colaizzi’s phenomenological approach.After conducting separate data analyses,the findings were integrated through side-by-side comparison and joint display.Results:Quantitative results revealed a non-linear,“V”-shaped trajectory of FR,significantly influenced by educational level,conception via assisted reproduction,farming occupation,coping style,psychological resilience,family functioning,and social support.Qualitative findings identified four themes:initial uncertainty and emotional distress,post-discharge anxiety,gradual adaptation,and eventual stabilization.Integrated mixed-methods findings revealed that the initial confusion phase demands a comprehensive response to family needs(T0);the post-discharge bottleneck requires addressing the care capability-needs gap(T1);the role adaptation phase is pivotal for enhancing internal family resources(T2);and the family-work transition necessitates enhanced work-family facilitation(T3).Conclusions:This study systematically identifies the unique“V”-shaped trajectory of FR in Chinese families with PIs and its key influencing factors,and accurately analyzes their dynamic experiences and adaptation across four stages.These findings provide an empirical basis for stage-specific targeted interventions,strongly support the practical advancement of the family-centered care model,and deliver critical guidance for enhancing FR.
文摘This study explores the influence of after-school tutoring on reading comprehension skills of students with dyslexia(DD)in grades 3-5 in China and its participating factors.Using a mixed-methods design,the quantitative data(GORT-4 reading test)of 50 public primary school students in Qingdao and their parents’feedback were collected through questionnaires,supplemented by semi-structured interviews with eight parents for qualitative analysis.The findings are as follows:(1)Family socioeconomic status and parents’awareness of DD are the key factors to participate in after-school counseling;(2)The students who participated in the after-school counseling performed significantly better in the GORT-4 comprehension test(P<0.05);(3)Counseling makes up for the lack of classroom learning through personalized strategies(such as multi-sensory teaching and phonological awareness training),but parents’psychological support is the core of successful intervention.The necessity of early targeted intervention was emphasized,and practical enlightenment was provided for the educational support system of DD students in China.
基金supported by the China Postdoctoral Science Foundation(Grant No.2021M703366)Shenzhen Science and Technology Program(Grant No.KQTD20190929172835662).
文摘Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.
基金supported by“Dalian Maritime University Teaching Reform Research Fund 2022 Annual Project”(Fund No.XJG2022-96).
文摘This paper proposes an interdisciplinary talent training model that combines foreign language education with area studies.The model aims to cultivate international ocean affairs professionals with cross-cultural communication skills,in-depth regional and country knowledge,and practical expertise in ocean affairs.Additionally,the paper presents specific training pathways and policy recommendations for implementing this model.
文摘In modern society,the globalization of literary works is evident,with exceptional literary pieces from various countries spreading worldwide.Among these,children’s literature,due to the specificity of its target audience,imposes distinct requirements on children’s books,compelling translators to approach the text from a child’s perspective.“The Little Prince”has renowned both within and outside of China,and a careful reading of this work can provide us with much inspiration.To this end,the present study adopts the perspective of Gideon Toury’s Descriptive Translation Studies to conduct an in-depth analysis of the different English and Chinese translations in conjunction with the original French novel.This approach aims to better guide literary research and explores translation methods for children’s literature through the analysis of translation norms and rules.
基金supported by the Science and Technology Fund Project of Guizhou Health Commission(gzwkj2025-163)。
文摘Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth interviews with patients and families,anchored by Interactive Patient Par ticipation Theory,to analyze 4 high-severity adverse drug events(ADE)cases.Cases were purposively sampled from 8 communities in China's National Adverse Event Monitor Center(2018-2023).Semi-structured interviews explored patient perspectives,with data analyzed via thematic coding and triangulation against clinical records.Results:Five interconnected themes emerged:(1)erosion of trust,(2)communication breakdowns,(3)information asymmetry,(4)environmental inadequacies,and(5)technological alienation.Notably,75% of participants had≤high school education,and 50% used≥7 medications daily,compounding ADE risks.Conclusions:We considered elements mentioned by theory,exploring trust,communication,information,and suppor t as the root causes.In addition,we added“adaptability to new technology”as an impor tant and necessary component.It is impor tant and necessary to analyze typical adverse drug events from the perspectives of patients.
文摘China ranked first worldwide in the production and export of electric bicycles.As an emerging market for electric bicycles,Malaysia holds significant potential for trade collabor ation with China in this sector.This study presents a compar ative analysis of the national electric bicycle standards in China and Malaysia,offering technical insights from a standardization perspective.These insights aim to support Chinese enterprises in strategically positioning their technologies in the Malaysian market.The findings reveal significant differences in technical parameters,safety requirements,and testing methods,highlighting the need for tailored product adapt ation.
基金supported by Project of Higher Education Teaching Reform Research in Heilongjiang Province(Graduate Education)(Grant No.SJGYY2024030).
文摘This paper investigates the teaching reform of the Program Comprehension and Analysis course in the context of industry-education integration and AI empowerment.To align with the evolving needs of the software industry,the course content has been updated to incorporate AI techniques such as large language models and deep learning.The reform enriches educational resources and introduces innovative instructional approaches.In addition,high-quality practical teaching cases have been developed,and immersive,hands-on learning experiences have been designed based on industrial platforms and real-world applications.These initiatives aim to enhance the practical skills and innovative thinking of professional degree graduate students,fostering high-caliber talent that aligns with industry demands.A survey of 90 graduate students revealed high levels of satisfaction regarding course content,teaching methodology,and skill development.The reform has proven effective in cultivating interdisciplinary professionals with solid foundations in software engineering and AI-driven innovation.
文摘Mindfulness would enhance university students’emotional well-being and study engagement.However,the role of affect(positive and negative emotions)and psychological resources(psychological capital)linking mindfulness to study engagement remain underexplored.This cross-sectional study surveyed 688 Chinese university students(females=413,mean age=20.3,SD=0.83),using validated self-report measures of mindfulness,positive and negative emotions,psychological capital,and study engagement.Structural equation modeling and bias-corrected bootstrap analyses(5000 resamples)revealed that mindfulness directly enhanced positive emotions,psychological capital,and study engagement,while reducing negative emotions.Positive emotions partially mediated the positive effect of mindfulness on psychological capital and study engagement.Negative emotions partially and negatively mediated only the mindfulness-psychological capital link.Psychological capital independently mediated the mindfulness-engagement relationship,and two sequential mediation pathways emerged:(a)mindfulness→positive emotions→psychological capital→higher study engagement and(b)mindfulness→reduced negative emotions→psychological capital→higher study engagement.Consistent with broaden-and-build(B&B)theory and Conservation of Resources(COR)theory,these findings suggest that mindfulness fosters study engagement primarily by promoting positive emotional experiences and strengthening psychological capital.By implication,university student support programs should employ mindfulness-based interventions to cultivate emotional and psychological resources for higher students’engagement and overall well-being.
文摘BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as expanding treatment indications,which affect the fair distribution of medical resources.There is limited research on ethical issues in the field of digestive endoscopy.AIM To investigate the level of ethical awareness among gastrointestinal endoscopy practitioners and analyze the ethical issues involved in gastrointestinal endoscopy technology.METHODS A questionnaire survey was performed to collect relevant data(gender,age,degree of education,professional title,personnel category,the level of understanding medical ethical principles,ethics training and its learning pathways)from gastrointestinal endoscopy practitioners at the Second Hospital of Dalian Medical University and Dalian Friendship Hospital,including licensed physicians and nurses(including trainees and graduate students).RESULTS The majority of gastrointestinal endoscopy practitioners have received training on ethics,but there is still considerable room for improvement in their ethical awareness.Different learning pathways may affect the mastery of ethical principles, and understanding of ethical principles is more easily achieved through hospital ethics institutions.CONCLUSIONTo address the ethical issues in gastrointestinal endoscopy technology, it is necessary to enhance the humanisticeducation of gastrointestinal endoscopy practitioners, incorporate ethical standards into the technology assessmentprocess, and establish a patient-centered diagnostic and treatment model to improve the ethical awareness of practitionersand achieve a balance between technology and ethics.
基金supported by the National Key Research and Development Program of China(2023YFA1508004)the National Natural Science Foundation of China(T2293692,22502164,92472203,22222903,52271229,22472074,22272069,22361132532,and 22021001)+6 种基金the Industry-University-Research Joint Innovation Project of Fujian Province(2023H6029)the Beijing National Laboratory for Molecular Sciences(BNLMS202305)the Scientific and Technological Project of Yunnan Precious Metals Laboratory(YPML-20240502063)the Liaoning Binhai Laboratory(Grant No.2024-05)the State Key Laboratory of Fine Chemicals,Dalian University of Technology(KF 2401)the Postdoctoral Fellowship Program of CPSF under Grant Number GZC20240897the China Postdoctoral Science Foundation(No.2025M770016).
文摘Escalating global energy demands and climate urgency necessitate advanced electrochemical energy conversion and storage technologies(EECSTs)like electrocatalysis and rechargeable batteries.Improving their performance relies on elucidating reaction mechanisms and structure-performance relationships via in situ studies.This review summarizes recent in situ studies of EECSTs through a variety of advanced characterization techniques aiming at mapping reaction pathways for the rational design of overall high-performance reaction systems.We outline the principles,capabilities,advantages,and limitations of various in situ techniques.Their applications in in situ studies of fuel cells,water/CO_(2)electrolysis,and lithium batteries are highlighted with representative examples.These studies enable dynamic tracking of chemical and structural evolution of overall reaction systems,including materials,intermediates,products,and surroundings during operation,providing insights critical to rational system design.Future advancements will involve integrating multimodal in situ/operando approaches with artificial intelligence to enable real-time monitoring at practical scales.Such integration promises precise mechanistic insights and robust structure-performance correlations,ultimately accelerating the development of high-performance EECSTs aligned with sustainability and market requirements.
文摘Objectives:In recent years,mental health has emerged as a pressing public health concern in China,driven by mounting societal pressures and fast-paced urban lifestyles.Physical activity,a well-established means of enhancing psychological well-being,has received growing scholarly and policy attention.This study uses panel data from the 2020 and 2022 waves of the China Family Panel Studies(CFPS)to examine the impact of exercise frequency on mental health(with indicators such as CESD-8 depression scores)among college students and young employees,thereby providing empirical support for targeted mental health interventions.Methods:This study examines the relationship between individual exercise frequency and mental health among college students and young employees,using panel data from the 2020 and 2022 waves of the China Family Panel Studies(CFPS),with the Chinese version of the 8-item Center for Epidemiologic Studies Depression Scale(CESD-8)depression scores,self-rated health,and life satisfaction as outcome variables.Specifically,this study tests three hypotheses:(H1)increased exercise frequency significantly reduces depression symptoms and enhances well-being;(H2)the effects of exercise vary by social roles,with stronger mental health benefits among employed individuals and those with lower education;and(H3)lifestyle factors such as smoking amount,sleep duration,and Body Mass Index(BMI)partially mediate the relationship between exercise and mental health.Employing a two-way fixed effects model,baseline results indicate that a one-unit increase in exercise frequency significantly reduces the CESD-8 score by 0.183 points.To address potential endogeneity and spurious regression concerns,an instrumental variable(IV)approach is further applied.The heterogeneity analysis differentiates between students and employed individuals.Results:Among students,the effects of exercise on mental health are not statistically significant,regardless of education level.In contrast,for the employed,exercise demonstrates a significant positive impact on mental health,with particularly pronounced effects among those with lower educational attainment.These findings underscore the importance of promoting exercise as part of comprehensive mental health strategies.Mediation analysis indicates that the beneficial effect of exercise on mental health is partially transmitted through reductions in adverse health behaviors,especially smoking.Conclusions:Policymakers should integrate physical activity promotion into health interventions,prioritizing vulnerable groups to enhance psychological resilience and foster inclusive,health-oriented development.
文摘AIM:To investigate the potential causal associations between 41 inflammatory cytokines and myopia using a two-sample Mendelian randomization(MR)approach.METHODS:Publicly available genome-wide association study(GWAS)datasets were utilized for this two-sample MR analysis.Inflammatory cytokine-related GWAS data were extracted from The University of Bristol’s Research Data Repository,and myopia-related GWAS data were obtained from the FinnGen project.Single nucleotide polymorphisms(SNPs)associated with inflammatory cytokines were systematically selected as instrumental variables(IVs)based on three rigorous criteria:relevance,independence,and exclusion of pleiotropy.Five MR methods were employed for causal inference:the inverse-variance weighted(IVW)method as the primary analysis,supplemented by MREgger regression,weighted median estimator,simple mode,and weighted mode approaches.Sensitivity analyses were performed to evaluate the robustness of the causal estimates.RESULTS:A total of 773 myopia-associated SNPs were identified.MR analysis revealed that higher levels of macrophage inflammatory protein 1-α(MIP-1α)were associated with a 17%reduced risk of myopia[odds ratio(OR)=0.83;95%confidence interval(CI):0.69-0.99;P<0.05].In contrast,elevated levels of eotaxin(OR=1.26;95%CI:1.07-1.47;P<0.01),stromal cell-derived factor-1α(SDF-1α;OR=1.68;95%CI:1.08-2.62;P<0.05),and interleukin-2 receptor subunit alpha(IL-2Rα;OR=1.25;95%CI:1.01-1.53;P<0.05)were significantly associated with an increased risk of myopia.Sensitivity analyses confirmed the reliability of these results.CONCLUSION:This study provides evidence supporting a causal relationship between specific inflammatory cytokines and myopia.MIP-1αmay act as a protective factor against myopia,while eotaxin,SDF-1α,and IL-2Rαare potential risk factors for myopia.These findings emphasize the critical role of inflammatory pathways in the pathogenesis of myopia,offering novel insights for the development of preventive and therapeutic strategies for myopia.
基金Capital Health Development Scientific Research Project(2020-2-4064)National Key Research and Development Program of China(2018YFC2002502).
文摘Objective Patients with atherosclerotic cardiovascular disease(ASCVD)following percutaneous coronary intervention(PCI)are classified as very-high-risk individuals in cardiovascular disease(CVD)risk stratification.The distribution pattern of traditional Chinese medicine(TCM)syndromes in this patient population,as well as its association with blood lipid profiles and clinical prognosis,remains unclear.The present prospective cohort study aims to investigate these correlations,thereby providing insights to enrich the research fields.Methods We enrolled consecutive patients with ASCVD who underwent PCI at the Integrated Cardiology Unit of China-Japan Friendship Hospital between September 1,2020 and December 31,2022.Demographics and clinical characteristics,signs and symptoms defining each TCM syndrome,and fasting venous blood samples were collected at baseline and follow up or upon major adverse cardiovascular events(MACEs).We analyzed the correlation between TCM syndromes,blood lipid profiles,and MACEs,and developed a new joint prognostic model incorporating both TCM syndromes and blood lipids using logistic regression.The analyses were based on detailed baseline and one-year follow-up data.Results A per-protocol analysis was performed on 586 patients with complete data ultimately.During the one-year follow-up,174 patients(29.69%)experienced a MACE.We performed statistical analyses on comorbidities,medication,and biochemical indicators across groups defined by TCM syndrome differentiation.When comparing different TCM syndromes,no significant differences were found in age,body mass index(BMI),history of revascularization,comorbidities,family history of CVD,smoking or drinking,or statin intensity(P>0.05).Patients with intertwined phlegm and blood stasis syndrome exhibited significantly higher levels of total cholesterol(TC,5.27±1.18 mmol/L,P<0.001),triglyceride(TG,1.96±1.33 mmol/L,P=0.008),low-density lipoprotein cholesterol(LDL-C,3.35±0.79 mmol/L,P<0.001),and high-density lipoprotein cholesterol(HDL-C,1.24±0.81 mmol/L,P<0.001)compared with those with other TCM syndromes combined.A multivariable logistic regression model was constructed to predict MACEs.The model included TCM syndrome type[with intertwined phlegm and blood stasis as a predictor,adjusted odds ratio(OR)=1.413,95%confidence interval(CI):0.517–3.864,P=0.501],age(adjusted OR=0.97,95%CI:0.955–1.001,P=0.057),male gender(adjusted OR=0.698,95%CI:0.416–1.170,P=0.173),TC(adjusted OR=1.004,95%CI:0.513–1.965,P=0.990),and LDL-C(adjusted OR=5.825,95%CI:2.214–15.326,P<0.001).This model demonstrated good discriminatory ability for MACEs in post-PCI ASCVD patients[the area under the receiver operating characteristic(ROC)curve(AUC)=0.865,95%CI:0.816–0.914].Conclusion The intertwined phlegm and blood stasis TCM syndrome is associated with a distinct atherogenic lipid profile characterized by elevated levels of TC and LDL-C.The prognostic model that incorporates this TCM syndrome type along with conventional lipid parameters(TC and LDL-C)shows good discriminatory ability for predicting MACEs in ASCVD patients after PCI,underscoring the potential clinical utility of integrating TCM syndrome differentiation into CVD risk assessment.
文摘Objective:To analyze factors affecting the utilization of human immunodeficiency virus counseling and testing(HCT)service among human immunodeficiency virus risk groups at Hessa Air Genting Health Center,Asahan Regency,North Sumatera,Indonesia.Methods:This quantitative unmatched case-control study was conducted from April 2024 to April 2025 at Hessa Air Genting Health Center,Asahan Regency,North Sumatra Province,Indonesia.Female sex workers and men who have sex with men were selected using purposive sampling based on predefined inclusion and exclusion criteria.Data were collected via questionnaires and analyzed using SPSS version 18.0,with univariate analysis,bivariate analysis(Chi-square test),and multivariate analysis(logistic regression analysis).Results:Comprehensive analysis of 75 cases and 75 controls was conducted to identify factors affecting the utilization of HCT services.Specifically,this study identified significant effects of knowledge(OR 3.2,95%CI 1.5-7.0,P=0.003),perception(OR 5.6,95%CI 2.5-12.5,P<0.001),information media(OR 3.1,95%CI 1.4-6.8,P=0.005),and health workers encouragement(OR 4.0,95%CI 1.5-10.4,P=0.005).In contrast,access to health services did not have a significant effect.Conclusions:Knowledge,perception,information media,and health worker encouragement had significant effects on HCT service utilization,with perception identified as the dominant factor.To improve utilization,strengthening positive perceptions,targeted training for healthcare workers,strengthened partnerships with local non-governmental organizations,and the use of social media for health promotion are recommended.
基金supported by the High-level Talents Introduction Plan from Central South University(No.502045003)the National Natural Science Foundation of China(No.42277438)Hunan Provincial Natural Science Foundation for Distinguished Young Scholars(No.2024JJ2082)to Fang Xiao,and the Postgraduate Independent Exploration and Innovation Project of Central South University,China(Nos.2024ZZTS0557 and 2023ZZTS0993)。
文摘Existing evidence suggests residential greenness is beneficial to human,while no research to date explored the associations of greenness with age-related macular degeneration(AMD).To evaluate the association of greenness with AMD,modification and mediation effect of air pollution,we conducted this prospective study.We con-structed weighted quantile sum(WQS)index as co-exposure to nitrogen oxides(NO_(x)),particulate matter<2.5μm(PM_(2.5)),particulate matter<10μm(PM10).Stratified Cox regression models were applied to test the effect of exposure.Effect modification of air pollution was assessed.Stratified Cox models through the indirect method and Aalen additive risk models were used in mediation analysis.Over median follow-up of 11.67 years,4596 AMD events were ascertained.Hazard ratios(HRs)and 95%confidence intervals(95%CIs)of incident AMD for pollution per interquartile range(IQR)increment were 1.10(1.04–1.16)for nitrogen dioxide(NO_(2)),1.09(1.03–1.15)for NO_(x),1.14(1.05–1.24)for PM_(2.5),1.13(1.05–1.21)for PM10.The HR(95%CI)of AMD associated with greenness 1000 m buffer per IQR increment was 0.91(0.86–0.97),300 m buffer was 0.94(0.89–0.99).The as-sociation between greenness 1000 m and AMD was 28.59%,44.77%,35.59%,32.31%and 27.08%mediated by the decreased WQS index,NO_(2),NO_(x),PM_(2.5) and PM10,respectively.Increased greenness was associated with lower AMD incidence,and air pollution partly mediate it,which implies that interventions aimed at improving air quality and increasing greenness could have a dual benefit in mitigating AMD risk.
文摘Background:Despite highly effective vaccines against SARS-CoV-2,COVID-19 vaccine hesitancy persisted in some populations in England during the pandemic,with rates and motivations for hesitancy varying by demographic group.Addressing the drivers of vaccine hesitancy through targeted interventions in hesitant groups is a public health priority for better and more rapid control of disease spread.We aimed to characterise the determinants and subtypes of vaccine hesitancy and identify more persistent forms of hesitancy via analysis of vaccine uptake in a large cross-sectional cohort with linked National Health Service(NHS)data.
