BACKGROUND Post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a prevalent and potentially serious complication in patients undergoing endoscopic retrograde cholangiopancreatography.AIM To comprehe...BACKGROUND Post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a prevalent and potentially serious complication in patients undergoing endoscopic retrograde cholangiopancreatography.AIM To comprehensively assess the efficacy of indomethacin therapy in reducing PEP risk.METHODS We searched PubMed,EMBASE,Scopus,and Cochrane Library databases to identify randomized controlled trials(RCTs)that compared rectal indomethacin with a control group to prevent PEP.Duplicates were removed,and studies were included based on the established inclusion criteria.We used the Cochrane Collaboration’s tool to assess the risk of bias in the RCTs.A random-effects model was applied to produce pooled risk ratios(RRs)with 95%confidence intervals(CIs).RESULTS We included a total of 30 RCTs involving 16977 patients.Compared to the control group,rectal indomethacin showed comparable rates of overall PEP(PEP;RR=0.85,95%CI:0.69-1.04,I2=79%)with no statistically significant difference of RR in mild(RR=0.92,95%CI:0.74-1.14),moderate(RR=0.78,95%CI:0.59-1.02),or severe PEP(RR=1.12,95%CI:0.75-1.67).There was also no difference in cases of adverse events(RR=0.97,95%CI:0.69-1.35),abdominal pain(RR=1.14,95%CI:0.80-1.62),bleeding(RR=1.07,95%CI:0.70-1.63),or mortality(RR=0.86,95%CI:0.56-1.33)between the two groups.Subgroup analyses were also performed.CONCLUSION Rectal indomethacin appears to be safe and may offer benefit in selected high-risk patients,though findings should be interpreted with caution due to high heterogeneity.展开更多
Challenges in the prevention and treatment of mild cognitive impairment associated with Alzheimer's disease:Increased life expectancy due to advancements in medical care has given rise to an aging population,accom...Challenges in the prevention and treatment of mild cognitive impairment associated with Alzheimer's disease:Increased life expectancy due to advancements in medical care has given rise to an aging population,accompanied by a surge in the incidence of incurable neurodegenerative diseases(NDDs).These diseases primarily affect the cognitive and behavioral functions of older adults by impacting brain activity.Mild cognitive impairment(MCI)is a neurodegenerative condition that affects a significant portion of the population.展开更多
Alzheimer’s disease,a devastating neurodegenerative disorder,is characterized by progressive cognitive decline,primarily due to amyloid-beta protein deposition and tau protein phosphorylation.Effectively reducing the...Alzheimer’s disease,a devastating neurodegenerative disorder,is characterized by progressive cognitive decline,primarily due to amyloid-beta protein deposition and tau protein phosphorylation.Effectively reducing the cytotoxicity of amyloid-beta42 aggregates and tau oligomers may help slow the progression of Alzheimer’s disease.Conventional drugs,such as donepezil,can only alleviate symptoms and are not able to prevent the underlying pathological processes or cognitive decline.Currently,active and passive immunotherapies targeting amyloid-beta and tau have shown some efficacy in mice with asymptomatic Alzheimer’s disease and other transgenic animal models,attracting considerable attention.However,the clinical application of these immunotherapies demonstrated only limited efficacy before the discovery of lecanemab and donanemab.This review first discusses the advancements in the pathogenesis of Alzheimer’s disease and active and passive immunotherapies targeting amyloid-beta and tau proteins.Furthermore,it reviews the advantages and disadvantages of various immunotherapies and considers their future prospects.Although some antibodies have shown promise in patients with mild Alzheimer’s disease,substantial clinical data are still lacking to validate their effectiveness in individuals with moderate Alzheimer’s disease.展开更多
The rise of the aging population parallels the rapidly increasing cases of neurological disorders. This puts pressure on scientists and physicians to find novel methods that can prevent and treat neurodegeneration. Th...The rise of the aging population parallels the rapidly increasing cases of neurological disorders. This puts pressure on scientists and physicians to find novel methods that can prevent and treat neurodegeneration. The brain is made up of a complex network of different cell types that work in tandem to maintain systemic homeostasis.展开更多
Objective Alzheimer’s disease(AD)presents a significant global health challenge with a steadily increasing prevalence and impact.This comprehensive review aimed to delve into the epidemiology,pathophysiology,pharmaco...Objective Alzheimer’s disease(AD)presents a significant global health challenge with a steadily increasing prevalence and impact.This comprehensive review aimed to delve into the epidemiology,pathophysiology,pharmacological therapies,emerging research,challenges,and future directions of AD.Major findings from recent studies were synthesised,encompassing insights into the global prevalence,molecular pathology,high-risk factors,and therapeutic interventions,including cholinesterase inhibitors,glutamate receptor antagonists,and antibodies against Aβand tau proteins.Additionally,emerging research areas such as gene therapy and lipid nanoparticles were highlighted.This review emphasised the urgent need for ongoing research on novel therapeutic avenues and addressing the challenges in AD diagnosis,treatment,and care.Future perspectives underscore the potential of disease-modifying treatments,personalised medical approaches,and holistic interventions to alleviate the growing burden of AD on individuals,families,and healthcare systems worldwide.By fostering collaboration and innovation,we can strive towards a future where effective prevention,early detection,and personalised treatments enhance the lives of millions affected by AD globally.展开更多
The problem of gastric cancer(GC)prevention remains relevant for a long time.Various methods of population serological screening of atrophic gastritis and precancerous changes in the gastric mucosa have been created a...The problem of gastric cancer(GC)prevention remains relevant for a long time.Various methods of population serological screening of atrophic gastritis and precancerous changes in the gastric mucosa have been created at present.Modern endoscopic and morphological methods of verification of the diagnosis of precancerous diseases and changes in the gastric mucosa have been introduced into the practice of gastroenterologists and oncologists.GC risk stratification systems allow the formation of risk groups that require population screening.Practical hints for population serological screening of atrophic gastritis,endoscopic and morphological verification of precancerous changes and diseases of the stomach recommend using it:When developing state programs for the prevention of stomach cancer;when implementing preventive measures for stomach cancer by doctors of all specialties;the authors also offer the possibility of use by anyone over the age of 40,provided that they seek methodological help from their doctor;in the work of health schools in any medical and preventive institutions.The use of an assessment system of certain risk factor signatures with prognostic value would add significant assistance to preventive measures against GC.展开更多
Apical microsurgery is accurate and minimally invasive,produces few complications,and has a success rate of more than 90%.However,due to the lack of awareness and understanding of apical microsurgery by dental general...Apical microsurgery is accurate and minimally invasive,produces few complications,and has a success rate of more than 90%.However,due to the lack of awareness and understanding of apical microsurgery by dental general practitioners and even endodontists,many clinical problems remain to be overcome.The consensus has gathered well-known domestic experts to hold a series of special discussions and reached the consensus.This document specifies the indications,contraindications,preoperative preparations,operational procedures,complication prevention measures,and efficacy evaluation of apical microsurgery and is applicable to dentists who perform apical microsurgery after systematic training.展开更多
In 1999,China released its first edition of the“Guidelines for the Prevention and Treatment of Hypertension”,which was subsequently updated in 2005,2010,and 2018,establishing a diagnostic,assessment,grading,stratifi...In 1999,China released its first edition of the“Guidelines for the Prevention and Treatment of Hypertension”,which was subsequently updated in 2005,2010,and 2018,establishing a diagnostic,assessment,grading,stratification,prevention,intervention,and management framework for hypertension tailored to the unique characteristics of the Chinese population.Over the past two decades,these guidelines have been widely implemented in clinical practice across China and have played a significant role in the management of hypertension and chronic diseases,the development of grassroots guidelines,the formulation of clinical pathways,and the implementation of health insurance policies.展开更多
To investigate the effect of saturation on the storage-dissipation properties and failure characteristics of red sandstone,as well as the energy mechanism of rockburst prevention by water,a series of uniaxial compress...To investigate the effect of saturation on the storage-dissipation properties and failure characteristics of red sandstone,as well as the energy mechanism of rockburst prevention by water,a series of uniaxial compression and uniaxial loading–unloading tests were conducted under five saturation levels.The effect of saturation on the mechanical properties and elastic energy density was analyzed,and a method for obtaining peak energy density was proposed.The effect of saturation on the energy evolution was examined,and the energy mechanism of water in preventing rockburst was revealed.The results indicate that an increase in saturation of red sandstone decreases the input energy density,elastic energy density,dissipated energy density,peak strength and peak strain;the compaction phase of the stress–strain curve becomes shorter;the failure mode transitions from X-conjugate oblique shear to single oblique shear;the variation in the debris ejection trajectory is as follows:radiation→X-ray→oblique upward parabola→horizontal parabola→oblique downward parabola;the degree of failure intensity and fragmentation is decreased gradually.Elastic energy density is interconnected with both saturation and stress but independent of the loading path.Saturation exhibits a dual effect on the energy storage property,i.e.,increasing saturation increases the energy storage efficiency and reduces the energy storage capacity.The ratio of peak elastic energy density to peak input energy density remains constant irrespective of saturation levels.Water prevents rockburst by decreasing the energy storage capacity of surrounding rock,alleviating the stress of surrounding rock to reduce energy storage,and elevating the energy release threshold of high-energy surrounding rock.The findings of this study contribute to understanding the effect of water on rock failure from an energy perspective,as well as provide theoretical guidance for rockburst prevention by water in deep tunnels.展开更多
BACKGROUND Elderly patients undergoing laparoscopic colorectal cancer surgery are at high risk for hypothermia-related complications.This study explores the efficacy of periop-erative composite insulation intervention...BACKGROUND Elderly patients undergoing laparoscopic colorectal cancer surgery are at high risk for hypothermia-related complications.This study explores the efficacy of periop-erative composite insulation interventions in maintaining normothermia and reducing postoperative risks in this vulnerable group.AIM To evaluate the efficacy of perioperative composite insulation in older patients undergoing colorectal cancer surgery.METHODS We selected 100 older patients who underwent laparoscopic surgery for colorectal cancer at Huzhou Central Hospital from September 2023 to April 2024.Using a random number table,patients were divided into a control group and inter-vention group of 50 patients each.After returning to the regular ward,the con-ventional group received traditional insulation intervention measures,while the intervention group received composite insulation nursing intervention.We ob-served and recorded postoperative blood pressure and heart rate changes,as well as postoperative anesthesia recovery time and incidence of complications.RESULTS The statistical results showed significant differences(P<0.05)in heart rate changes and systolic blood pressure between the two groups.There was a sig-nificant change in heart rate between the groups immediately after surgery and at 15 and 30 minutes after surgery(P<0.05).The heart rate and systolic blood pressure of the intervention group were significantly lower than those of the control group at 15 and 30 minutes after surgery(P<0.05).The rewarming time of the intervention group was shorter than that of the control group,and the overall incidence of postoperative complications was significantly lower than that of the control group(P<0.05).CONCLUSION For elderly patients undergoing laparoscopic colorectal cancer surgery,a composite insulation intervention during the perioperative period can maintain body temperature,reduce postoperative stress,and significantly reduce the incidence of hypothermia and related complications.展开更多
Purpose–This study aims to propose a cooperative adhesion control method for trains with multiple motors electric locomotives.The method is intended to optimize the output torque of each motor,maximize the utilizatio...Purpose–This study aims to propose a cooperative adhesion control method for trains with multiple motors electric locomotives.The method is intended to optimize the output torque of each motor,maximize the utilization of train adhesion within the total torque command,reduce the train skidding/sliding phenomenon and achieve optimal adhesion utilization for each axle,thus realizing the optimal allocation of the multi-motor electric locomotives.Design/methodology/approach–In this study,a model predictive control(MPC)-based cooperative maximum adhesion tracking control method for multi-motor electric locomotives is presented.Firstly,train traction system with multiple motors is constructed in accordance with Newton’s second law.These equations include the train dynamics equations,the axle dynamics equations,and the wheel-rail adhesion coefficient equations.Then,a new MPC-based multi-axle adhesion co-optimization method is put forward.This method calculates the optimal output torque through real-time iteration based on the known reference slip speed to achieve multi-axle co-optimization under different circumstances.Findings–This paper presents a MPC system designed for the cooperative control of multi-axle adhesion.The results indicate that the proposed control system is able to optimize the adhesion of multiple axles under numerous different conditions and achieve the optimal power distribution based on the reduction of train skidding/sliding.Originality/value–This study presents a novel cooperative adhesion tracking control scheme.It is designed for multi-motor electric locomotives,which has rarely been studied before.And simulations are carried out in different conditions,including variable surfaces and motor failing.展开更多
With the implementation of significant national strategies and rapid socioeconomic development,many ultra-long deep tunnels are being constructed in the Qinghai–Xizang Plateau region.However,the extreme complexity an...With the implementation of significant national strategies and rapid socioeconomic development,many ultra-long deep tunnels are being constructed in the Qinghai–Xizang Plateau region.However,the extreme complexity and variability of the environment in this region pose significant challenges to the safe construction and long-term operation of the planned or under-construction ultra-long deep tunnels.To address these complex technical challenges,this paper provides a detailed analysis of the complex climate and geology features of the Qinghai–Xizang Plateau during tunnel construction.The climate characteristics of the Qinghai–Xizang Plateau include severe coldness,low oxygen,and unpredictable weather changes.The geological characteristics include complex stress distributions caused by the intense internal and external dynamic coupling of tectonic plates,widespread active tectonic structures,frequent high-intensity earthquakes,fractured rock masses,and numerous active fault zones.Based on the analysis,this paper elaborates on potential sources of major disasters resulting from the characteristics of ultra-long deep tunnel projects in the Qinghai–Xizang Plateau region.These potential disaster sources include the crossing of active fault zones,high geostress rockbursts,large deformation disasters,high-pressure water surges,geothermal hazards,inadequate long-distance ventilation and oxygen supply,and multi-hazard couplings.In response to these challenges,this paper systematically summarizes the latest research progress and technological achievements in the domestic and international literature,and proposes innovative ideas and future development prospects for disaster monitoring and early warning,mechanized intelligent construction,long-term safety services,and emergency security and rescue.These innovative measures are intended to address the challenges of tunnel disaster prevention and control in the complex environment of the Qinghai–Xizang Plateau,contributing to the safe construction and long-term operation of ultra-long deep tunnels in this region.展开更多
Enamel demineralization,the formation of white spot lesions,is a common issue in clinical orthodontic treatment.The appearance of white spot lesions not only affects the texture and health of dental hard tissues but a...Enamel demineralization,the formation of white spot lesions,is a common issue in clinical orthodontic treatment.The appearance of white spot lesions not only affects the texture and health of dental hard tissues but also impacts the health and aesthetics of teeth after orthodontic treatment.The prevention,diagnosis,and treatment of white spot lesions that occur throughout the orthodontic treatment process involve multiple dental specialties.This expert consensus will focus on providing guiding opinions on the management and prevention of white spot lesions during orthodontic treatment,advocating for proactive prevention,early detection,timely treatment,scientific follow-up,and multidisciplinary management of white spot lesions throughout the orthodontic process,thereby maintaining the dental health of patients during orthodontic treatment.展开更多
BACKGROUND Ischemic heart disease(IHD)impacts the quality of life and has the highest mortality rate of cardiovascular diseases globally.AIM To compare variations in the parameters of the single-lead electrocardiogram...BACKGROUND Ischemic heart disease(IHD)impacts the quality of life and has the highest mortality rate of cardiovascular diseases globally.AIM To compare variations in the parameters of the single-lead electrocardiogram(ECG)during resting conditions and physical exertion in individuals diagnosed with IHD and those without the condition using vasodilator-induced stress computed tomography(CT)myocardial perfusion imaging as the diagnostic reference standard.METHODS This single center observational study included 80 participants.The participants were aged≥40 years and given an informed written consent to participate in the study.Both groups,G1(n=31)with and G2(n=49)without post stress induced myocardial perfusion defect,passed cardiologist consultation,anthropometric measurements,blood pressure and pulse rate measurement,echocardiography,cardio-ankle vascular index,bicycle ergometry,recording 3-min single-lead ECG(Cardio-Qvark)before and just after bicycle ergometry followed by performing CT myocardial perfusion.The LASSO regression with nested cross-validation was used to find the association between Cardio-Qvark parameters and the existence of the perfusion defect.Statistical processing was performed with the R programming language v4.2,Python v.3.10[^R],and Statistica 12 program.RESULTS Bicycle ergometry yielded an area under the receiver operating characteristic curve of 50.7%[95%confidence interval(CI):0.388-0.625],specificity of 53.1%(95%CI:0.392-0.673),and sensitivity of 48.4%(95%CI:0.306-0.657).In contrast,the Cardio-Qvark test performed notably better with an area under the receiver operating characteristic curve of 67%(95%CI:0.530-0.801),specificity of 75.5%(95%CI:0.628-0.88),and sensitivity of 51.6%(95%CI:0.333-0.695).CONCLUSION The single-lead ECG has a relatively higher diagnostic accuracy compared with bicycle ergometry by using machine learning models,but the difference was not statistically significant.However,further investigations are required to uncover the hidden capabilities of single-lead ECG in IHD diagnosis.展开更多
Aiming at reducing the dust pollution during the tunneling process and improving the application efficiency of air curtain dust prevention technology,according to the changes of radial jet velocity(v_(r)),axial extrac...Aiming at reducing the dust pollution during the tunneling process and improving the application efficiency of air curtain dust prevention technology,according to the changes of radial jet velocity(v_(r)),axial extraction velocity(v_(e))and extraction distance(L)in the formation process of air curtain,the numerical simulation method was used to analyze the rules of airflow structure evolution and the diffusion characteristics of dust particles in fully mechanized excavation tunnel.The results indicate that as v_(r) and v_(e) increase,the migration path of the wall jet of the air curtain changes into an axial direction;as L decreases,the migration distance increases accordingly.These phenomena make the airflow distribution in the working face tends to be uniform.The dust diffusion distance reduces as well,wherein,the range of the discrete area of dust particles decreases sharply,until all dust particles are concentrated in the accumulation area.On this basis,the v_(r),v_(e) and L were optimized and applied in the 63_(up) 08 fully mechanized working face.By the application of the optimal parameters,the average dust removal efficiency at the driver’s position increased by 71%.The dust concentration was reduced and the working environment had been improved effectively.展开更多
Colorectal cancer(CRC)is the third most commonly diagnosed cancer and the second leading cause of cancer death worldwide.The leading risk factors for CRC include male gender,age over 50,family history,obesity,tobacco ...Colorectal cancer(CRC)is the third most commonly diagnosed cancer and the second leading cause of cancer death worldwide.The leading risk factors for CRC include male gender,age over 50,family history,obesity,tobacco smoking,alco-hol consumption,and unhealthy diet.CRC screening methods vary considerably between countries and depend on incidence,economic resources and healthcare structure.Important aspects of screening include adherence,which can vary signi-ficantly across ethnic and socioeconomic groups.Basic concepts of CRC screening include pre-stratification of patients by identifying risk factors and then using fecal immunochemical test or guaiac-based fecal occult blood test and/or colono-scopy or radiologic imaging techniques.Technological capabilities for CRC scree-ning are rapidly evolving and include stool DNA test,liquid biopsy,virtual colo-nography,and the use of artificial intelligence.A CRC prevention strategy should be comprehensive and include active patient education along with targeted imple-mentation of screening.展开更多
The evacuation of people under threat is an effective disaster prevention and mitigation measure in response to flash floods and geological hazards,and it is also an essential element of pre-disaster planning.However,...The evacuation of people under threat is an effective disaster prevention and mitigation measure in response to flash floods and geological hazards,and it is also an essential element of pre-disaster planning.However,the effect of the interactions between perception factors on residents'willingness to evacuate is an urgent problem to be solved.Therefore,this paper introduces risk,stakeholder,and protective action perceptions from the protective action decision model as the main explanatory variables.These three core perceptions are subdivided into affective risk perception,cognitive risk perception,government perception,other-stakeholder perception,resourcerelated attributes,and hazard-related attributes.A questionnaire survey was conducted from June to July 2023 among residents of mountainous communities in nine villages in three towns in Sichuan Province,China.359 cross-sectional data were analyzed using structural equation modeling to explore the effects of six perception factors on evacuation intentions.The results of the study showed that:(1)affective risk perception,government perception,other-stakeholder perception,and hazard-related attributes all directly and positively influence residents'intentions to evacuate;(2)cognitive risk perception is mediated by stakeholder and protective action perceptions,which indirectly and positively affect residents'intentions to evacuate.Based on the hypothesized paths,strategies to improve residents'willingness to evacuate are discussed from the perspective of three core perceptions:strengthening disaster risk education,improving residents'cohesion,and building government credibility.The results of this study can provide theoretical support and practical suggestions for emergency management departments to formulate emergency evacuation strategies,which can aid decision-makers in better understanding residents'intentions to evacuate,optimizing evacuation information dissemination pathways,and strengthening disaster risk management capabilities.展开更多
Trauma is a major cause of morbidity and mortality across the globe accounting for significant health burden.Relevance of trauma care revolves round prevention,planning and execution of safety regulations.Acquisition ...Trauma is a major cause of morbidity and mortality across the globe accounting for significant health burden.Relevance of trauma care revolves round prevention,planning and execution of safety regulations.Acquisition of the actual data regarding the type of trauma,affected age group,timings of trauma occurrence,involved part of the body constitute the initial steps in the building of the composite overview of the epidemiology of trauma.In succession,would be the measures directed towards avoidance of trauma and capacity building of trauma center.展开更多
Stroke and Alzheimer's disease are common neurological disorders and often occur in the same individuals.The comorbidity of the two neurological disorders represents a grave health threat to older populations.This...Stroke and Alzheimer's disease are common neurological disorders and often occur in the same individuals.The comorbidity of the two neurological disorders represents a grave health threat to older populations.This review presents a brief background of the development of novel concepts and their clinical potentials.The activity of glutamatergic N-methyl-D-aspartate receptors and N-methyl-D-aspartate receptor-mediated Ca^(2+)influx is critical for neuronal function.An ischemic insult induces prompt and excessive glutamate release and drastic increases of intracellular Ca^(2+)mainly via N-methyl-D-aspartate receptors,particularly of those at the extrasynaptic site.This Ca^(2+)-evoked neuronal cell death in the ischemic core is dominated by necrosis within a few hours and days known as acute excitotoxicity.Furthermore,mild but sustained Ca^(2+)increases under neurodegenerative conditions such as in the distant penumbra of the ischemic brain and early stages of Alzheimer's disease are not immediately toxic,but gradually set off deteriorating Ca^(2+)-dependent signals and neuronal cell loss mostly because of activation of programmed cell death pathways.Based on the Ca^(2+)hypothesis of Alzheimer's disease and recent advances,this Ca^(2+)-activated“silent”degenerative excitotoxicity evolves from years to decades and is recognized as a unique slow and chronic neuropathogenesis.The N-methyl-D-aspartate receptor subunit GluN3A,primarily at the extrasynaptic site,serves as a gatekeeper for the N-methyl-D-aspartate receptor activity and is neuroprotective against both acute and chronic excitotoxicity.Ischemic stroke and Alzheimer's disease,therefore,share an N-methyl-D-aspartate receptor-and Ca^(2+)-mediated mechanism,although with much different time courses.It is thus proposed that early interventions to control Ca^(2+)homeostasis at the preclinical stage are pivotal for individuals who are susceptible to sporadic late-onset Alzheimer's disease and Alzheimer's disease-related dementia.This early treatment simultaneously serves as a preconditioning therapy against ischemic stroke that often attacks the same individuals during abnormal aging.展开更多
Kawasaki disease(KD)is a significant pediatric vasculitis known for its potential to cause severe coronary artery complications.Despite the effectiveness of initial treatments,such as intravenous immunoglobulin,KD pat...Kawasaki disease(KD)is a significant pediatric vasculitis known for its potential to cause severe coronary artery complications.Despite the effectiveness of initial treatments,such as intravenous immunoglobulin,KD patients can experience long-term cardiovascular issues,as evidenced by a recent case report of an adult who suffered a ST-segment elevation myocardial infarction due to previous KD in the World Journal of Clinical Cases.This editorial emphasizes the critical need for long-term management and regular surveillance to prevent such complications.By drawing on recent research and case studies,we advocate for a structured approach to follow-up care that includes routine cardiac evaluations and preventive measures.展开更多
文摘BACKGROUND Post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a prevalent and potentially serious complication in patients undergoing endoscopic retrograde cholangiopancreatography.AIM To comprehensively assess the efficacy of indomethacin therapy in reducing PEP risk.METHODS We searched PubMed,EMBASE,Scopus,and Cochrane Library databases to identify randomized controlled trials(RCTs)that compared rectal indomethacin with a control group to prevent PEP.Duplicates were removed,and studies were included based on the established inclusion criteria.We used the Cochrane Collaboration’s tool to assess the risk of bias in the RCTs.A random-effects model was applied to produce pooled risk ratios(RRs)with 95%confidence intervals(CIs).RESULTS We included a total of 30 RCTs involving 16977 patients.Compared to the control group,rectal indomethacin showed comparable rates of overall PEP(PEP;RR=0.85,95%CI:0.69-1.04,I2=79%)with no statistically significant difference of RR in mild(RR=0.92,95%CI:0.74-1.14),moderate(RR=0.78,95%CI:0.59-1.02),or severe PEP(RR=1.12,95%CI:0.75-1.67).There was also no difference in cases of adverse events(RR=0.97,95%CI:0.69-1.35),abdominal pain(RR=1.14,95%CI:0.80-1.62),bleeding(RR=1.07,95%CI:0.70-1.63),or mortality(RR=0.86,95%CI:0.56-1.33)between the two groups.Subgroup analyses were also performed.CONCLUSION Rectal indomethacin appears to be safe and may offer benefit in selected high-risk patients,though findings should be interpreted with caution due to high heterogeneity.
基金supported by The Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Education(RS-2023-00244901)(to RB)。
文摘Challenges in the prevention and treatment of mild cognitive impairment associated with Alzheimer's disease:Increased life expectancy due to advancements in medical care has given rise to an aging population,accompanied by a surge in the incidence of incurable neurodegenerative diseases(NDDs).These diseases primarily affect the cognitive and behavioral functions of older adults by impacting brain activity.Mild cognitive impairment(MCI)is a neurodegenerative condition that affects a significant portion of the population.
基金supported by the Nature Science Foundation of Liaoning Province,Nos.2022-MS-211,2021-MS-064,and 2024-MS-048(all to YC).
文摘Alzheimer’s disease,a devastating neurodegenerative disorder,is characterized by progressive cognitive decline,primarily due to amyloid-beta protein deposition and tau protein phosphorylation.Effectively reducing the cytotoxicity of amyloid-beta42 aggregates and tau oligomers may help slow the progression of Alzheimer’s disease.Conventional drugs,such as donepezil,can only alleviate symptoms and are not able to prevent the underlying pathological processes or cognitive decline.Currently,active and passive immunotherapies targeting amyloid-beta and tau have shown some efficacy in mice with asymptomatic Alzheimer’s disease and other transgenic animal models,attracting considerable attention.However,the clinical application of these immunotherapies demonstrated only limited efficacy before the discovery of lecanemab and donanemab.This review first discusses the advancements in the pathogenesis of Alzheimer’s disease and active and passive immunotherapies targeting amyloid-beta and tau proteins.Furthermore,it reviews the advantages and disadvantages of various immunotherapies and considers their future prospects.Although some antibodies have shown promise in patients with mild Alzheimer’s disease,substantial clinical data are still lacking to validate their effectiveness in individuals with moderate Alzheimer’s disease.
文摘The rise of the aging population parallels the rapidly increasing cases of neurological disorders. This puts pressure on scientists and physicians to find novel methods that can prevent and treat neurodegeneration. The brain is made up of a complex network of different cell types that work in tandem to maintain systemic homeostasis.
文摘Objective Alzheimer’s disease(AD)presents a significant global health challenge with a steadily increasing prevalence and impact.This comprehensive review aimed to delve into the epidemiology,pathophysiology,pharmacological therapies,emerging research,challenges,and future directions of AD.Major findings from recent studies were synthesised,encompassing insights into the global prevalence,molecular pathology,high-risk factors,and therapeutic interventions,including cholinesterase inhibitors,glutamate receptor antagonists,and antibodies against Aβand tau proteins.Additionally,emerging research areas such as gene therapy and lipid nanoparticles were highlighted.This review emphasised the urgent need for ongoing research on novel therapeutic avenues and addressing the challenges in AD diagnosis,treatment,and care.Future perspectives underscore the potential of disease-modifying treatments,personalised medical approaches,and holistic interventions to alleviate the growing burden of AD on individuals,families,and healthcare systems worldwide.By fostering collaboration and innovation,we can strive towards a future where effective prevention,early detection,and personalised treatments enhance the lives of millions affected by AD globally.
文摘The problem of gastric cancer(GC)prevention remains relevant for a long time.Various methods of population serological screening of atrophic gastritis and precancerous changes in the gastric mucosa have been created at present.Modern endoscopic and morphological methods of verification of the diagnosis of precancerous diseases and changes in the gastric mucosa have been introduced into the practice of gastroenterologists and oncologists.GC risk stratification systems allow the formation of risk groups that require population screening.Practical hints for population serological screening of atrophic gastritis,endoscopic and morphological verification of precancerous changes and diseases of the stomach recommend using it:When developing state programs for the prevention of stomach cancer;when implementing preventive measures for stomach cancer by doctors of all specialties;the authors also offer the possibility of use by anyone over the age of 40,provided that they seek methodological help from their doctor;in the work of health schools in any medical and preventive institutions.The use of an assessment system of certain risk factor signatures with prognostic value would add significant assistance to preventive measures against GC.
文摘Apical microsurgery is accurate and minimally invasive,produces few complications,and has a success rate of more than 90%.However,due to the lack of awareness and understanding of apical microsurgery by dental general practitioners and even endodontists,many clinical problems remain to be overcome.The consensus has gathered well-known domestic experts to hold a series of special discussions and reached the consensus.This document specifies the indications,contraindications,preoperative preparations,operational procedures,complication prevention measures,and efficacy evaluation of apical microsurgery and is applicable to dentists who perform apical microsurgery after systematic training.
文摘In 1999,China released its first edition of the“Guidelines for the Prevention and Treatment of Hypertension”,which was subsequently updated in 2005,2010,and 2018,establishing a diagnostic,assessment,grading,stratification,prevention,intervention,and management framework for hypertension tailored to the unique characteristics of the Chinese population.Over the past two decades,these guidelines have been widely implemented in clinical practice across China and have played a significant role in the management of hypertension and chronic diseases,the development of grassroots guidelines,the formulation of clinical pathways,and the implementation of health insurance policies.
基金supported by the National Natural Science Foundation of China(52104133,52304227)the Natural Science Foundation of Hunan Province(2021JJ40465,2023JJ40548)the Opening Foundation of the State Key Laboratory of Mining Response and Disaster Prevention and Control in Deep Coal Mines(SKLMRDPC20KF03).
文摘To investigate the effect of saturation on the storage-dissipation properties and failure characteristics of red sandstone,as well as the energy mechanism of rockburst prevention by water,a series of uniaxial compression and uniaxial loading–unloading tests were conducted under five saturation levels.The effect of saturation on the mechanical properties and elastic energy density was analyzed,and a method for obtaining peak energy density was proposed.The effect of saturation on the energy evolution was examined,and the energy mechanism of water in preventing rockburst was revealed.The results indicate that an increase in saturation of red sandstone decreases the input energy density,elastic energy density,dissipated energy density,peak strength and peak strain;the compaction phase of the stress–strain curve becomes shorter;the failure mode transitions from X-conjugate oblique shear to single oblique shear;the variation in the debris ejection trajectory is as follows:radiation→X-ray→oblique upward parabola→horizontal parabola→oblique downward parabola;the degree of failure intensity and fragmentation is decreased gradually.Elastic energy density is interconnected with both saturation and stress but independent of the loading path.Saturation exhibits a dual effect on the energy storage property,i.e.,increasing saturation increases the energy storage efficiency and reduces the energy storage capacity.The ratio of peak elastic energy density to peak input energy density remains constant irrespective of saturation levels.Water prevents rockburst by decreasing the energy storage capacity of surrounding rock,alleviating the stress of surrounding rock to reduce energy storage,and elevating the energy release threshold of high-energy surrounding rock.The findings of this study contribute to understanding the effect of water on rock failure from an energy perspective,as well as provide theoretical guidance for rockburst prevention by water in deep tunnels.
文摘BACKGROUND Elderly patients undergoing laparoscopic colorectal cancer surgery are at high risk for hypothermia-related complications.This study explores the efficacy of periop-erative composite insulation interventions in maintaining normothermia and reducing postoperative risks in this vulnerable group.AIM To evaluate the efficacy of perioperative composite insulation in older patients undergoing colorectal cancer surgery.METHODS We selected 100 older patients who underwent laparoscopic surgery for colorectal cancer at Huzhou Central Hospital from September 2023 to April 2024.Using a random number table,patients were divided into a control group and inter-vention group of 50 patients each.After returning to the regular ward,the con-ventional group received traditional insulation intervention measures,while the intervention group received composite insulation nursing intervention.We ob-served and recorded postoperative blood pressure and heart rate changes,as well as postoperative anesthesia recovery time and incidence of complications.RESULTS The statistical results showed significant differences(P<0.05)in heart rate changes and systolic blood pressure between the two groups.There was a sig-nificant change in heart rate between the groups immediately after surgery and at 15 and 30 minutes after surgery(P<0.05).The heart rate and systolic blood pressure of the intervention group were significantly lower than those of the control group at 15 and 30 minutes after surgery(P<0.05).The rewarming time of the intervention group was shorter than that of the control group,and the overall incidence of postoperative complications was significantly lower than that of the control group(P<0.05).CONCLUSION For elderly patients undergoing laparoscopic colorectal cancer surgery,a composite insulation intervention during the perioperative period can maintain body temperature,reduce postoperative stress,and significantly reduce the incidence of hypothermia and related complications.
基金supported by Scientific Research Projects of China Association of Metros(CAMET-KY-2022039)State Key Laboratory of Traction and Control System of EMU and Locomotive(2023YJ386).
文摘Purpose–This study aims to propose a cooperative adhesion control method for trains with multiple motors electric locomotives.The method is intended to optimize the output torque of each motor,maximize the utilization of train adhesion within the total torque command,reduce the train skidding/sliding phenomenon and achieve optimal adhesion utilization for each axle,thus realizing the optimal allocation of the multi-motor electric locomotives.Design/methodology/approach–In this study,a model predictive control(MPC)-based cooperative maximum adhesion tracking control method for multi-motor electric locomotives is presented.Firstly,train traction system with multiple motors is constructed in accordance with Newton’s second law.These equations include the train dynamics equations,the axle dynamics equations,and the wheel-rail adhesion coefficient equations.Then,a new MPC-based multi-axle adhesion co-optimization method is put forward.This method calculates the optimal output torque through real-time iteration based on the known reference slip speed to achieve multi-axle co-optimization under different circumstances.Findings–This paper presents a MPC system designed for the cooperative control of multi-axle adhesion.The results indicate that the proposed control system is able to optimize the adhesion of multiple axles under numerous different conditions and achieve the optimal power distribution based on the reduction of train skidding/sliding.Originality/value–This study presents a novel cooperative adhesion tracking control scheme.It is designed for multi-motor electric locomotives,which has rarely been studied before.And simulations are carried out in different conditions,including variable surfaces and motor failing.
文摘With the implementation of significant national strategies and rapid socioeconomic development,many ultra-long deep tunnels are being constructed in the Qinghai–Xizang Plateau region.However,the extreme complexity and variability of the environment in this region pose significant challenges to the safe construction and long-term operation of the planned or under-construction ultra-long deep tunnels.To address these complex technical challenges,this paper provides a detailed analysis of the complex climate and geology features of the Qinghai–Xizang Plateau during tunnel construction.The climate characteristics of the Qinghai–Xizang Plateau include severe coldness,low oxygen,and unpredictable weather changes.The geological characteristics include complex stress distributions caused by the intense internal and external dynamic coupling of tectonic plates,widespread active tectonic structures,frequent high-intensity earthquakes,fractured rock masses,and numerous active fault zones.Based on the analysis,this paper elaborates on potential sources of major disasters resulting from the characteristics of ultra-long deep tunnel projects in the Qinghai–Xizang Plateau region.These potential disaster sources include the crossing of active fault zones,high geostress rockbursts,large deformation disasters,high-pressure water surges,geothermal hazards,inadequate long-distance ventilation and oxygen supply,and multi-hazard couplings.In response to these challenges,this paper systematically summarizes the latest research progress and technological achievements in the domestic and international literature,and proposes innovative ideas and future development prospects for disaster monitoring and early warning,mechanized intelligent construction,long-term safety services,and emergency security and rescue.These innovative measures are intended to address the challenges of tunnel disaster prevention and control in the complex environment of the Qinghai–Xizang Plateau,contributing to the safe construction and long-term operation of ultra-long deep tunnels in this region.
基金funded with National Key R&D Program of China(2022YFC2405904)National Natural Science Foundation of China(11932012,and 32171348).
文摘Enamel demineralization,the formation of white spot lesions,is a common issue in clinical orthodontic treatment.The appearance of white spot lesions not only affects the texture and health of dental hard tissues but also impacts the health and aesthetics of teeth after orthodontic treatment.The prevention,diagnosis,and treatment of white spot lesions that occur throughout the orthodontic treatment process involve multiple dental specialties.This expert consensus will focus on providing guiding opinions on the management and prevention of white spot lesions during orthodontic treatment,advocating for proactive prevention,early detection,timely treatment,scientific follow-up,and multidisciplinary management of white spot lesions throughout the orthodontic process,thereby maintaining the dental health of patients during orthodontic treatment.
基金Supported by Government Assignment,No.1023022600020-6RSF Grant,No.24-15-00549Ministry of Science and Higher Education of the Russian Federation within the Framework of State Support for the Creation and Development of World-Class Research Center,No.075-15-2022-304.
文摘BACKGROUND Ischemic heart disease(IHD)impacts the quality of life and has the highest mortality rate of cardiovascular diseases globally.AIM To compare variations in the parameters of the single-lead electrocardiogram(ECG)during resting conditions and physical exertion in individuals diagnosed with IHD and those without the condition using vasodilator-induced stress computed tomography(CT)myocardial perfusion imaging as the diagnostic reference standard.METHODS This single center observational study included 80 participants.The participants were aged≥40 years and given an informed written consent to participate in the study.Both groups,G1(n=31)with and G2(n=49)without post stress induced myocardial perfusion defect,passed cardiologist consultation,anthropometric measurements,blood pressure and pulse rate measurement,echocardiography,cardio-ankle vascular index,bicycle ergometry,recording 3-min single-lead ECG(Cardio-Qvark)before and just after bicycle ergometry followed by performing CT myocardial perfusion.The LASSO regression with nested cross-validation was used to find the association between Cardio-Qvark parameters and the existence of the perfusion defect.Statistical processing was performed with the R programming language v4.2,Python v.3.10[^R],and Statistica 12 program.RESULTS Bicycle ergometry yielded an area under the receiver operating characteristic curve of 50.7%[95%confidence interval(CI):0.388-0.625],specificity of 53.1%(95%CI:0.392-0.673),and sensitivity of 48.4%(95%CI:0.306-0.657).In contrast,the Cardio-Qvark test performed notably better with an area under the receiver operating characteristic curve of 67%(95%CI:0.530-0.801),specificity of 75.5%(95%CI:0.628-0.88),and sensitivity of 51.6%(95%CI:0.333-0.695).CONCLUSION The single-lead ECG has a relatively higher diagnostic accuracy compared with bicycle ergometry by using machine learning models,but the difference was not statistically significant.However,further investigations are required to uncover the hidden capabilities of single-lead ECG in IHD diagnosis.
基金financially supported by the Natural Science Foundation of Shandong Province(ZR2020QE124,ZR2023ME031 and ZR2023ME012)Innovation Achievement Cultivation Project of Qingdao University of Technology(CLZ2022-002)National Natural Science Foundation of China(52404222 and 52374209).
文摘Aiming at reducing the dust pollution during the tunneling process and improving the application efficiency of air curtain dust prevention technology,according to the changes of radial jet velocity(v_(r)),axial extraction velocity(v_(e))and extraction distance(L)in the formation process of air curtain,the numerical simulation method was used to analyze the rules of airflow structure evolution and the diffusion characteristics of dust particles in fully mechanized excavation tunnel.The results indicate that as v_(r) and v_(e) increase,the migration path of the wall jet of the air curtain changes into an axial direction;as L decreases,the migration distance increases accordingly.These phenomena make the airflow distribution in the working face tends to be uniform.The dust diffusion distance reduces as well,wherein,the range of the discrete area of dust particles decreases sharply,until all dust particles are concentrated in the accumulation area.On this basis,the v_(r),v_(e) and L were optimized and applied in the 63_(up) 08 fully mechanized working face.By the application of the optimal parameters,the average dust removal efficiency at the driver’s position increased by 71%.The dust concentration was reduced and the working environment had been improved effectively.
文摘Colorectal cancer(CRC)is the third most commonly diagnosed cancer and the second leading cause of cancer death worldwide.The leading risk factors for CRC include male gender,age over 50,family history,obesity,tobacco smoking,alco-hol consumption,and unhealthy diet.CRC screening methods vary considerably between countries and depend on incidence,economic resources and healthcare structure.Important aspects of screening include adherence,which can vary signi-ficantly across ethnic and socioeconomic groups.Basic concepts of CRC screening include pre-stratification of patients by identifying risk factors and then using fecal immunochemical test or guaiac-based fecal occult blood test and/or colono-scopy or radiologic imaging techniques.Technological capabilities for CRC scree-ning are rapidly evolving and include stool DNA test,liquid biopsy,virtual colo-nography,and the use of artificial intelligence.A CRC prevention strategy should be comprehensive and include active patient education along with targeted imple-mentation of screening.
基金supported by the National Natural Science Foundation of China(U20A20111)the National key R&D Program(2022YFC3080100)。
文摘The evacuation of people under threat is an effective disaster prevention and mitigation measure in response to flash floods and geological hazards,and it is also an essential element of pre-disaster planning.However,the effect of the interactions between perception factors on residents'willingness to evacuate is an urgent problem to be solved.Therefore,this paper introduces risk,stakeholder,and protective action perceptions from the protective action decision model as the main explanatory variables.These three core perceptions are subdivided into affective risk perception,cognitive risk perception,government perception,other-stakeholder perception,resourcerelated attributes,and hazard-related attributes.A questionnaire survey was conducted from June to July 2023 among residents of mountainous communities in nine villages in three towns in Sichuan Province,China.359 cross-sectional data were analyzed using structural equation modeling to explore the effects of six perception factors on evacuation intentions.The results of the study showed that:(1)affective risk perception,government perception,other-stakeholder perception,and hazard-related attributes all directly and positively influence residents'intentions to evacuate;(2)cognitive risk perception is mediated by stakeholder and protective action perceptions,which indirectly and positively affect residents'intentions to evacuate.Based on the hypothesized paths,strategies to improve residents'willingness to evacuate are discussed from the perspective of three core perceptions:strengthening disaster risk education,improving residents'cohesion,and building government credibility.The results of this study can provide theoretical support and practical suggestions for emergency management departments to formulate emergency evacuation strategies,which can aid decision-makers in better understanding residents'intentions to evacuate,optimizing evacuation information dissemination pathways,and strengthening disaster risk management capabilities.
文摘Trauma is a major cause of morbidity and mortality across the globe accounting for significant health burden.Relevance of trauma care revolves round prevention,planning and execution of safety regulations.Acquisition of the actual data regarding the type of trauma,affected age group,timings of trauma occurrence,involved part of the body constitute the initial steps in the building of the composite overview of the epidemiology of trauma.In succession,would be the measures directed towards avoidance of trauma and capacity building of trauma center.
基金supported by National Health Institute(NIH)grant NS099596(to LW and SPY),NS114221(to LW and SPY)Veterans Affair(VA)SPiRE grant RX003865(to SPY)+1 种基金supported by the O.Wayne Rollins Endowment Fund(to SPY)John E.Steinhaus Endowment Fund(to LW)。
文摘Stroke and Alzheimer's disease are common neurological disorders and often occur in the same individuals.The comorbidity of the two neurological disorders represents a grave health threat to older populations.This review presents a brief background of the development of novel concepts and their clinical potentials.The activity of glutamatergic N-methyl-D-aspartate receptors and N-methyl-D-aspartate receptor-mediated Ca^(2+)influx is critical for neuronal function.An ischemic insult induces prompt and excessive glutamate release and drastic increases of intracellular Ca^(2+)mainly via N-methyl-D-aspartate receptors,particularly of those at the extrasynaptic site.This Ca^(2+)-evoked neuronal cell death in the ischemic core is dominated by necrosis within a few hours and days known as acute excitotoxicity.Furthermore,mild but sustained Ca^(2+)increases under neurodegenerative conditions such as in the distant penumbra of the ischemic brain and early stages of Alzheimer's disease are not immediately toxic,but gradually set off deteriorating Ca^(2+)-dependent signals and neuronal cell loss mostly because of activation of programmed cell death pathways.Based on the Ca^(2+)hypothesis of Alzheimer's disease and recent advances,this Ca^(2+)-activated“silent”degenerative excitotoxicity evolves from years to decades and is recognized as a unique slow and chronic neuropathogenesis.The N-methyl-D-aspartate receptor subunit GluN3A,primarily at the extrasynaptic site,serves as a gatekeeper for the N-methyl-D-aspartate receptor activity and is neuroprotective against both acute and chronic excitotoxicity.Ischemic stroke and Alzheimer's disease,therefore,share an N-methyl-D-aspartate receptor-and Ca^(2+)-mediated mechanism,although with much different time courses.It is thus proposed that early interventions to control Ca^(2+)homeostasis at the preclinical stage are pivotal for individuals who are susceptible to sporadic late-onset Alzheimer's disease and Alzheimer's disease-related dementia.This early treatment simultaneously serves as a preconditioning therapy against ischemic stroke that often attacks the same individuals during abnormal aging.
文摘Kawasaki disease(KD)is a significant pediatric vasculitis known for its potential to cause severe coronary artery complications.Despite the effectiveness of initial treatments,such as intravenous immunoglobulin,KD patients can experience long-term cardiovascular issues,as evidenced by a recent case report of an adult who suffered a ST-segment elevation myocardial infarction due to previous KD in the World Journal of Clinical Cases.This editorial emphasizes the critical need for long-term management and regular surveillance to prevent such complications.By drawing on recent research and case studies,we advocate for a structured approach to follow-up care that includes routine cardiac evaluations and preventive measures.
