China implemented its Action Plan of Air Pollution Prevention and Control(APAPPC)in 2013 as a major step in national air-quality management.This study treated the APAPPC as a quasi-experiment,drawing on the Grossman a...China implemented its Action Plan of Air Pollution Prevention and Control(APAPPC)in 2013 as a major step in national air-quality management.This study treated the APAPPC as a quasi-experiment,drawing on the Grossman and Cropper models,to examine how air pollution affected individual health capital and medical service demand.Using panel data from the China Health and Retirement Longitudinal Study for 2011,2013,2015,and 2018,the analysis applied a Heckman two-stage model and difference-in-differences estimation to identify the policy's effects on medical expenditure.The results showed that the APAPPC significantly reduced annual health spending,with stronger effects among women,older adults,and rural residents.The mechanism analysis indicated that the reduction in respiratory diseases played a key role.This study provides evidence that supports further airpollution control in China and offers useful insights for other developing countries.展开更多
Background:In 2021,the American College of Medical Genetics and Genomics(ACMG)recommended reporting actionable genotypes in 73 genes associated with diseases for which preventive or therapeutic measures are available....Background:In 2021,the American College of Medical Genetics and Genomics(ACMG)recommended reporting actionable genotypes in 73 genes associated with diseases for which preventive or therapeutic measures are available.Evaluations of the association of actionable genotypes in these genes with life span are currently lacking.展开更多
China’s coastal regions,characterized by dense populations and industrial agglomeration,face escalating threats from typhoon disasters.Understanding the evolution of socio-economic exposure to future typhoon landfall...China’s coastal regions,characterized by dense populations and industrial agglomeration,face escalating threats from typhoon disasters.Understanding the evolution of socio-economic exposure to future typhoon landfalls under global change is critical for effective disaster risk management.This study utilizes future typhoon track data simulated by the regional climate model version 4(RegCM4),combined with projected population and Gross Domestic Product(GDP)data for China’s coastal regions under three Shared Socioeconomic Pathways(SSPs:SSP1,sustainability;SSP2,middle of the road;SSP5,fossil-fueled development).We analyze typhoon impact zones for future periods(2030s,2050s,and 2090s)under Representative Concentration Pathways(RCPs:RCP2.6,RCP4.5,and RCP8.5,representing low,medium,and high greenhouse gas emission scenarios,respectively).Exposure levels for 2030,2050,and 2100 are calculated based on the annual average frequency of typhoon impacts during these periods,aiming to quantify the distribution characteristics of typhoon-affected population and GDP in China’s coastal regions.Key findings reveal two high-frequency typhoon im-pact zones:the Taiwan Strait region and the northern Qiongzhou Strait region.Furthermore,under RCP2.6,typhoon impacts may ex-tend to Liaoning,while RCP4.5 and RCP8.5 scenarios indicate potential impacts reaching further north to Heilongjiang.Under RCP4.5,Northeast China will experience the largest typhoon-affected area(43.800×10^(4) km^(2))by the 2030s.High population and GDP exposure concentrates in the Yangtze River Delta,the Pearl River Delta,and the Taiwan Strait coastal areas.Notably,Liaoning’s cumulative ex-posed population may exceed 0.100×10^(8) by 2030 and 2050 under RCP4.5 and RCP8.5 due to typhoon track migration.Given China’s location within the Western Pacific typhoon high-incidence region,the northward expansion of impacts will substantially escalate socio-economic exposure in mid-latitude regions previously at lower risk.These findings underscore the imperative for enhanced disaster pre-vention,mitigation strategies and targeted countermeasure research.展开更多
Acute exposure to high altitude can cause acute altitude illnesses and is associated with impaired cognitive and physical performance.The most effective preventive strategies currently recommended include environmenta...Acute exposure to high altitude can cause acute altitude illnesses and is associated with impaired cognitive and physical performance.The most effective preventive strategies currently recommended include environmental acclimatization(slow ascent and/or pre-acclimatization)or pharmacological support of acclimatization using acetazolamide.However,these strategies are not practical for high-altitude exposures that require rapid and unplanned ascent,high physical and mental performance,such as rescue missions or military operations.Dexamethasone and other modulators of the glucocorticoid system take effect quickly and are effective alternatives for preventing acute altitude illnesses when rapidly ascending to high altitudes.As the efficacy of dexamethasone in preventing acute mountain illnesses remains controversial,a review of existing studies on the use of dexamethasone for the prevention of acute mountain sickness was conducted,aiming to determine the best strategy.Possible mechanisms of protection against acute altitude illnesses are discussed based on the results of clinical trials.The data indicate that dexamethasone is most effective at altitudes above 4000 m at doses of 8–16 mg/d.Appropriately designed and powered trials are needed to obtain more evidence-based results on the dosage and timing of dexamethasone administration,and to provide optimized recommendations for the application of this powerful pharmacological tool.展开更多
AIM:To conduct a systematic review and Meta-analysis to determine the differential effects of combined lutein and zeaxanthin supplementation on myopia prevention in teenagers.It also investigates the effects of supple...AIM:To conduct a systematic review and Meta-analysis to determine the differential effects of combined lutein and zeaxanthin supplementation on myopia prevention in teenagers.It also investigates the effects of supplements dosage,intervention duration,and geographical variation on intervention results.METHODS:A systematic search and screening of randomized controlled trials(RCTs)completed between 2014 and 2023 was undertaken using the PubMed,EMBASE,Cochrane Library,and Web of Science databases,in accordance with the PRISMA recommendations.The Cochrane risk of bias method was used to assess the quality of the studies.A Meta-analysis was performed using Stata 17.0 to calculate standardized mean differences(SMDs)and 95%confidence intervals(CIs).Subgroup analyses were performed to look at the effects of different doses,intervention periods,and geographic areas.Additionally,publication bias was assessed using Egger’s test.RESULTS:Ten studies including 1035 participants with myopia were analyzed.Supplementation with lutein and zeaxanthin resulted in a significant reduction in axial length elongation among adolescents in the intervention group(SMD=-0.40,P=0.001),an increase in macular pigment optical density(SMD=0.50,P=0.010),and an enhancement in visual sensitivity(SMD=0.53,P=0.008).Subgroup analyses revealed that participants receiving high doses and those undergoing intervention for more than 12mo exhibited significantly improved outcomes compared to those in the low-dose and short-term groups(high-dose vs low-dose:SMD=-0.41 vs-0.22,P=0.003;>12mo vs 6-12mo:SMD=-0.43 vs-0.23,P=0.004,respectively).Furthermore,Egger’s test indicated no significant publication bias(P=0.094).CONCLUSION:Combined lutein and zeaxanthin supplementation has a significant effect on myopia prevention in adolescents,with more pronounced benefits observed in high-dose and long-term interventions.The findings provide scientific evidence for its use as an adjunctive approach in myopia control.展开更多
Citrus is the world's most produced fruit.With the rapid growth of citrus cultivation and processing industries globally,the volume of by-products,including dropped fruits,defective fruits,and waste generated duri...Citrus is the world's most produced fruit.With the rapid growth of citrus cultivation and processing industries globally,the volume of by-products,including dropped fruits,defective fruits,and waste generated during processing,has surged.Consequently,resource wastage and environmental pollution due to the low utilization rate of these by-products have become increasingly prominent issues.Currently,citrus by-products are directly utilized as seasonings,tea,and traditional Chinese medicine,or for the extraction of pectin,flavonoids,carotenoids,limonoids,essential oils,synephrine,and other functional ingredients.They are also processed into ethanol,citric acid,feed,and organic fertilizer through biomass fermentation.Despite these applications,the overall utilization rate of citrus by-products remains low.Additionally,there is a lack of key technologies and core equipment,and the production of high value-added functional products is limited.The future direction for citrus by-product utilization lies in green,low-carbon,high-efficiency,and high-value comprehensive recycling.To address the serious environmental pollution and recycling challenges posed by citrus rotting,it is proposed for the first time to develop new products and mold prevention strategies throughout the entire citrus supply chain-"Planting-field management-harvesting-transportation-storage"-to achieve a circular economy approach.This strategy aims to"Take from citrus and give back to citrus"effectively preventing and reducing citrus rotting.Furthermore,it can mitigate the significant economic losses caused by fruit decay and provide insights into the high-quality development of comprehensive citrus by-product utilization.展开更多
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
With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative...With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative rehabilitation nursing,as a crucial aspect of enhancing surgical outcomes,reducing complications,and facilitating patients’return to normal life,has its scientific and effective protocols directly influencing patient prognosis.This article systematically reviews the core research findings on rehabilitation nursing after joint replacement surgery based on the concept of evidence-based medicine,aiming to provide references for the formulation of standardized and personalized rehabilitation nursing plans in clinical settings.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
Rabies is a zoonotic disease with an estimated global mortality of 59,000 people annually and a burden of more than 3.7 million disability-adjusted life years(DALYs)that is caused by a neurotropic lyssavirus[1].Dogs a...Rabies is a zoonotic disease with an estimated global mortality of 59,000 people annually and a burden of more than 3.7 million disability-adjusted life years(DALYs)that is caused by a neurotropic lyssavirus[1].Dogs are the primary source of human rabies,as more than 95%of human cases can be traced to dogs[2,3].China faces a substantial burden of rabies,having endured three major human rabies epidemics,which occurred in the 1950s,1981,and 2007[4].Implementation of various prevention and control measures has decreased the number of human rabies cases from 3,300 in 2007 to 167 in 2024.In China.展开更多
BCL2-associated anthanogene 3 facilitates the clearance of tau protein aggregates:BCL2-associated anthanogene 3(BAG3)is a ubiquitously expressed and highly conserved multi-functional co-chaperone protein involved in m...BCL2-associated anthanogene 3 facilitates the clearance of tau protein aggregates:BCL2-associated anthanogene 3(BAG3)is a ubiquitously expressed and highly conserved multi-functional co-chaperone protein involved in many biological processes that supports cellular homeostasis,including the inhibition of apoptosis by preventing mitochondrial BAX localization(Lin et al.,2022)and the promotion of the degradation of hyperphosphorylated tau aggregates by its interactions with SQSTM1(p62)(Hamano and Mutoh,2022).展开更多
Healthy life expectancy is a pivotal measure of population health by integrating both life expectancy and the quality of years lived.A significant increase in life expectancy was evident in most populations during the...Healthy life expectancy is a pivotal measure of population health by integrating both life expectancy and the quality of years lived.A significant increase in life expectancy was evident in most populations during the past decades worldwide[1],but the growth in healthy life expectancy has generally lagged behind[2].China has made substantial strides in enhancing both life expectancy and healthy life expectancy.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
This study developed a modeling methodology for statistical optimization-based geologic hazard susceptibility assessment,aiming to enhance the comprehensive performance and classification accuracy of the assessment mo...This study developed a modeling methodology for statistical optimization-based geologic hazard susceptibility assessment,aiming to enhance the comprehensive performance and classification accuracy of the assessment models.First,the cumulative probability method revealed that a low probability(15%)of geologic hazards between any two geologic hazard points occurred outside a buffer zone with a radius of 2297 m(i.e.,the distance threshold).The training dataset was established,consisting of negative samples(non-hazard points)randomly generated based on the distance threshold,positive samples(i.e.,historical hazards),and 13 conditioning factors.Then,models were built using five machine learning algorithms,namely random forest(RF),gradient boosting decision tree(GBDT),naive Bayes(NB),logistic regression(LR),and support vector machine(SVM).The comprehensive performance of the models was assessed using the area under the receiver operating characteristic curve(AUC)and overall accuracy(OA)as indicators,revealing that RF exhibited the best performance,with OA and AUC values of 2.7127 and 0.981,respectively.Furthermore,the machine learning models constructed by considering the distance threshold outperformed those built using the unoptimized dataset.The characteristic factors were ranked using the mutual information method,with their scores decreasing in the order of rainfall(0.1616),altitude(0.06),normalized difference vegetation index(NDVI;0.04),and distance from roads(0.03).Finally,the geologic hazard susceptibility classification was assessed using the natural breaks method combined with a clustering algorithm.The results indicate that the clustering algorithm exhibited higher classification accuracy than the natural breaks method.The findings of this study demonstrate that the proposed model optimization scheme can provide a scientific basis for the prevention and control of geologic hazards.展开更多
As a critical department ensuring the sterility of hospital instruments,the Sterile Supply Center(SSC)directly impacts the sterility status of clinical instruments through its sterilization qualification rate.Geriatri...As a critical department ensuring the sterility of hospital instruments,the Sterile Supply Center(SSC)directly impacts the sterility status of clinical instruments through its sterilization qualification rate.Geriatric patients,due to physiological decline and compromised immune function,constitute a high-risk group for hospital-acquired infections,with more stringent requirements for instrument sterility.This paper analyzes the current status and influencing factors of sterilization qualification rates in SSCs,explores the mechanistic association between sterilization qualification rates and infections in geriatric departments,and proposes targeted strategies to improve sterilization qualification rates.It highlights the pivotal role of SSC instrument sterilization in infection prevention and control for geriatric patients,providing theoretical basis and practical guidance for optimizing SSC management,reducing infection rates in geriatric departments,and ensuring the safety of elderly patients’medical care.These findings aim to enhance overall infection management standards in hospitals.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
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
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
基金Natural Science Foundation of Hubei Province(No.2025AFC041).
文摘China implemented its Action Plan of Air Pollution Prevention and Control(APAPPC)in 2013 as a major step in national air-quality management.This study treated the APAPPC as a quasi-experiment,drawing on the Grossman and Cropper models,to examine how air pollution affected individual health capital and medical service demand.Using panel data from the China Health and Retirement Longitudinal Study for 2011,2013,2015,and 2018,the analysis applied a Heckman two-stage model and difference-in-differences estimation to identify the policy's effects on medical expenditure.The results showed that the APAPPC significantly reduced annual health spending,with stronger effects among women,older adults,and rural residents.The mechanism analysis indicated that the reduction in respiratory diseases played a key role.This study provides evidence that supports further airpollution control in China and offers useful insights for other developing countries.
文摘Background:In 2021,the American College of Medical Genetics and Genomics(ACMG)recommended reporting actionable genotypes in 73 genes associated with diseases for which preventive or therapeutic measures are available.Evaluations of the association of actionable genotypes in these genes with life span are currently lacking.
基金Under the auspices of National Key Research and Development Program of China(No.2017YFA0604902,2024YFF1306802)Natural Science Foundation of Fujian Province(No.2022J01497)Open Project of the Strait Meteorology Laboratory(No.2025KF03)。
文摘China’s coastal regions,characterized by dense populations and industrial agglomeration,face escalating threats from typhoon disasters.Understanding the evolution of socio-economic exposure to future typhoon landfalls under global change is critical for effective disaster risk management.This study utilizes future typhoon track data simulated by the regional climate model version 4(RegCM4),combined with projected population and Gross Domestic Product(GDP)data for China’s coastal regions under three Shared Socioeconomic Pathways(SSPs:SSP1,sustainability;SSP2,middle of the road;SSP5,fossil-fueled development).We analyze typhoon impact zones for future periods(2030s,2050s,and 2090s)under Representative Concentration Pathways(RCPs:RCP2.6,RCP4.5,and RCP8.5,representing low,medium,and high greenhouse gas emission scenarios,respectively).Exposure levels for 2030,2050,and 2100 are calculated based on the annual average frequency of typhoon impacts during these periods,aiming to quantify the distribution characteristics of typhoon-affected population and GDP in China’s coastal regions.Key findings reveal two high-frequency typhoon im-pact zones:the Taiwan Strait region and the northern Qiongzhou Strait region.Furthermore,under RCP2.6,typhoon impacts may ex-tend to Liaoning,while RCP4.5 and RCP8.5 scenarios indicate potential impacts reaching further north to Heilongjiang.Under RCP4.5,Northeast China will experience the largest typhoon-affected area(43.800×10^(4) km^(2))by the 2030s.High population and GDP exposure concentrates in the Yangtze River Delta,the Pearl River Delta,and the Taiwan Strait coastal areas.Notably,Liaoning’s cumulative ex-posed population may exceed 0.100×10^(8) by 2030 and 2050 under RCP4.5 and RCP8.5 due to typhoon track migration.Given China’s location within the Western Pacific typhoon high-incidence region,the northward expansion of impacts will substantially escalate socio-economic exposure in mid-latitude regions previously at lower risk.These findings underscore the imperative for enhanced disaster pre-vention,mitigation strategies and targeted countermeasure research.
文摘Acute exposure to high altitude can cause acute altitude illnesses and is associated with impaired cognitive and physical performance.The most effective preventive strategies currently recommended include environmental acclimatization(slow ascent and/or pre-acclimatization)or pharmacological support of acclimatization using acetazolamide.However,these strategies are not practical for high-altitude exposures that require rapid and unplanned ascent,high physical and mental performance,such as rescue missions or military operations.Dexamethasone and other modulators of the glucocorticoid system take effect quickly and are effective alternatives for preventing acute altitude illnesses when rapidly ascending to high altitudes.As the efficacy of dexamethasone in preventing acute mountain illnesses remains controversial,a review of existing studies on the use of dexamethasone for the prevention of acute mountain sickness was conducted,aiming to determine the best strategy.Possible mechanisms of protection against acute altitude illnesses are discussed based on the results of clinical trials.The data indicate that dexamethasone is most effective at altitudes above 4000 m at doses of 8–16 mg/d.Appropriately designed and powered trials are needed to obtain more evidence-based results on the dosage and timing of dexamethasone administration,and to provide optimized recommendations for the application of this powerful pharmacological tool.
文摘AIM:To conduct a systematic review and Meta-analysis to determine the differential effects of combined lutein and zeaxanthin supplementation on myopia prevention in teenagers.It also investigates the effects of supplements dosage,intervention duration,and geographical variation on intervention results.METHODS:A systematic search and screening of randomized controlled trials(RCTs)completed between 2014 and 2023 was undertaken using the PubMed,EMBASE,Cochrane Library,and Web of Science databases,in accordance with the PRISMA recommendations.The Cochrane risk of bias method was used to assess the quality of the studies.A Meta-analysis was performed using Stata 17.0 to calculate standardized mean differences(SMDs)and 95%confidence intervals(CIs).Subgroup analyses were performed to look at the effects of different doses,intervention periods,and geographic areas.Additionally,publication bias was assessed using Egger’s test.RESULTS:Ten studies including 1035 participants with myopia were analyzed.Supplementation with lutein and zeaxanthin resulted in a significant reduction in axial length elongation among adolescents in the intervention group(SMD=-0.40,P=0.001),an increase in macular pigment optical density(SMD=0.50,P=0.010),and an enhancement in visual sensitivity(SMD=0.53,P=0.008).Subgroup analyses revealed that participants receiving high doses and those undergoing intervention for more than 12mo exhibited significantly improved outcomes compared to those in the low-dose and short-term groups(high-dose vs low-dose:SMD=-0.41 vs-0.22,P=0.003;>12mo vs 6-12mo:SMD=-0.43 vs-0.23,P=0.004,respectively).Furthermore,Egger’s test indicated no significant publication bias(P=0.094).CONCLUSION:Combined lutein and zeaxanthin supplementation has a significant effect on myopia prevention in adolescents,with more pronounced benefits observed in high-dose and long-term interventions.The findings provide scientific evidence for its use as an adjunctive approach in myopia control.
基金supported by the National Natural Science Foundation of China(82104340)。
文摘Citrus is the world's most produced fruit.With the rapid growth of citrus cultivation and processing industries globally,the volume of by-products,including dropped fruits,defective fruits,and waste generated during processing,has surged.Consequently,resource wastage and environmental pollution due to the low utilization rate of these by-products have become increasingly prominent issues.Currently,citrus by-products are directly utilized as seasonings,tea,and traditional Chinese medicine,or for the extraction of pectin,flavonoids,carotenoids,limonoids,essential oils,synephrine,and other functional ingredients.They are also processed into ethanol,citric acid,feed,and organic fertilizer through biomass fermentation.Despite these applications,the overall utilization rate of citrus by-products remains low.Additionally,there is a lack of key technologies and core equipment,and the production of high value-added functional products is limited.The future direction for citrus by-product utilization lies in green,low-carbon,high-efficiency,and high-value comprehensive recycling.To address the serious environmental pollution and recycling challenges posed by citrus rotting,it is proposed for the first time to develop new products and mold prevention strategies throughout the entire citrus supply chain-"Planting-field management-harvesting-transportation-storage"-to achieve a circular economy approach.This strategy aims to"Take from citrus and give back to citrus"effectively preventing and reducing citrus rotting.Furthermore,it can mitigate the significant economic losses caused by fruit decay and provide insights into the high-quality development of comprehensive citrus by-product utilization.
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.
文摘With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative rehabilitation nursing,as a crucial aspect of enhancing surgical outcomes,reducing complications,and facilitating patients’return to normal life,has its scientific and effective protocols directly influencing patient prognosis.This article systematically reviews the core research findings on rehabilitation nursing after joint replacement surgery based on the concept of evidence-based medicine,aiming to provide references for the formulation of standardized and personalized rehabilitation nursing plans in clinical settings.
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Rabies is a zoonotic disease with an estimated global mortality of 59,000 people annually and a burden of more than 3.7 million disability-adjusted life years(DALYs)that is caused by a neurotropic lyssavirus[1].Dogs are the primary source of human rabies,as more than 95%of human cases can be traced to dogs[2,3].China faces a substantial burden of rabies,having endured three major human rabies epidemics,which occurred in the 1950s,1981,and 2007[4].Implementation of various prevention and control measures has decreased the number of human rabies cases from 3,300 in 2007 to 167 in 2024.In China.
基金supported by the award W81XWH1910309 (to HF) from the Department of Defensethe award R01-AG075092-01 (to HF)+2 种基金the award RF1AG063521 from the National Institute of Aging at the National Institutes of Healththe Neurological Research Institute Seed grant (to HF) from The Ohio State Universitythe Summer Undergraduate Research Fellowship (to NS) from The Ohio State University Chronic Brain Injury Discovery Theme
文摘BCL2-associated anthanogene 3 facilitates the clearance of tau protein aggregates:BCL2-associated anthanogene 3(BAG3)is a ubiquitously expressed and highly conserved multi-functional co-chaperone protein involved in many biological processes that supports cellular homeostasis,including the inhibition of apoptosis by preventing mitochondrial BAX localization(Lin et al.,2022)and the promotion of the degradation of hyperphosphorylated tau aggregates by its interactions with SQSTM1(p62)(Hamano and Mutoh,2022).
文摘Healthy life expectancy is a pivotal measure of population health by integrating both life expectancy and the quality of years lived.A significant increase in life expectancy was evident in most populations during the past decades worldwide[1],but the growth in healthy life expectancy has generally lagged behind[2].China has made substantial strides in enhancing both life expectancy and healthy life expectancy.
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.
基金supported by a project entitled Loess Plateau Region-Watershed-Slope Geological Hazard Multi-Scale Collaborative Intelligent Early Warning System of the National Key R&D Program of China(2022YFC3003404)a project of the Shaanxi Youth Science and Technology Star(2021KJXX-87)public welfare geological survey projects of Shaanxi Institute of Geologic Survey(20180301,201918,202103,and 202413)。
文摘This study developed a modeling methodology for statistical optimization-based geologic hazard susceptibility assessment,aiming to enhance the comprehensive performance and classification accuracy of the assessment models.First,the cumulative probability method revealed that a low probability(15%)of geologic hazards between any two geologic hazard points occurred outside a buffer zone with a radius of 2297 m(i.e.,the distance threshold).The training dataset was established,consisting of negative samples(non-hazard points)randomly generated based on the distance threshold,positive samples(i.e.,historical hazards),and 13 conditioning factors.Then,models were built using five machine learning algorithms,namely random forest(RF),gradient boosting decision tree(GBDT),naive Bayes(NB),logistic regression(LR),and support vector machine(SVM).The comprehensive performance of the models was assessed using the area under the receiver operating characteristic curve(AUC)and overall accuracy(OA)as indicators,revealing that RF exhibited the best performance,with OA and AUC values of 2.7127 and 0.981,respectively.Furthermore,the machine learning models constructed by considering the distance threshold outperformed those built using the unoptimized dataset.The characteristic factors were ranked using the mutual information method,with their scores decreasing in the order of rainfall(0.1616),altitude(0.06),normalized difference vegetation index(NDVI;0.04),and distance from roads(0.03).Finally,the geologic hazard susceptibility classification was assessed using the natural breaks method combined with a clustering algorithm.The results indicate that the clustering algorithm exhibited higher classification accuracy than the natural breaks method.The findings of this study demonstrate that the proposed model optimization scheme can provide a scientific basis for the prevention and control of geologic hazards.
文摘As a critical department ensuring the sterility of hospital instruments,the Sterile Supply Center(SSC)directly impacts the sterility status of clinical instruments through its sterilization qualification rate.Geriatric patients,due to physiological decline and compromised immune function,constitute a high-risk group for hospital-acquired infections,with more stringent requirements for instrument sterility.This paper analyzes the current status and influencing factors of sterilization qualification rates in SSCs,explores the mechanistic association between sterilization qualification rates and infections in geriatric departments,and proposes targeted strategies to improve sterilization qualification rates.It highlights the pivotal role of SSC instrument sterilization in infection prevention and control for geriatric patients,providing theoretical basis and practical guidance for optimizing SSC management,reducing infection rates in geriatric departments,and ensuring the safety of elderly patients’medical care.These findings aim to enhance overall infection management standards in hospitals.
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.
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.
