Geological prospecting and the identification of adverse geological features are essential in tunnel construction,providing critical information to ensure safety and guide engineering decisions.As tunnel projects exte...Geological prospecting and the identification of adverse geological features are essential in tunnel construction,providing critical information to ensure safety and guide engineering decisions.As tunnel projects extend into deeper and more mountainous terrains,engineers face increasingly complex geological conditions,including high water pressure,intense geo-stress,elevated geothermal gradients,and active fault zones.These conditions pose substantial risks such as high-pressure water inrush,largescale collapses,and tunnel boring machine(TBM)blockages.Addressing these challenges requires advanced detection technologies capable of long-distance,high-precision,and intelligent assessments of adverse geology.This paper presents a comprehensive review of recent advancements in tunnel geological ahead prospecting methods.It summarizes the fundamental principles,technical maturity,key challenges,development trends,and real-world applications of various detection techniques.Airborne and semi-airborne geophysical methods enable large-scale reconnaissance for initial surveys in complex terrain.Tunnel-and borehole-based approaches offer high-resolution detection during excavation,including seismic ahead prospecting(SAP),TBM rock-breaking source seismic methods,fulltime-domain tunnel induced polarization(TIP),borehole electrical resistivity,and ground penetrating radar(GPR).To address scenarios involving multiple,coexisting adverse geologies,intelligent inversion and geological identification methods have been developed based on multi-source data fusion and artificial intelligence(AI)techniques.Overall,these advances significantly improve detection range,resolution,and geological characterization capabilities.The methods demonstrate strong adaptability to complex environments and provide reliable subsurface information,supporting safer and more efficient tunnel construction.展开更多
Rowlands et al.1present an analysis of accelerometer data from the UK Biobank cohort,examining variations in the duration,intensity,and accumulation of moderate-intensity physical activity(MPA)and vigorous-intensity p...Rowlands et al.1present an analysis of accelerometer data from the UK Biobank cohort,examining variations in the duration,intensity,and accumulation of moderate-intensity physical activity(MPA)and vigorous-intensity physical activity(VPA)sufficient to reduce the risk of all-cause mortality.In this study,the authors questioned if shorter durations(i.e.,1,2,3,4,5,10,15,and 20 min/day)of MPA and VPA performed continuously or accumulated throughout the day would equally reduce the risks of all-cause mortality as longer duration MPA and VPA recommended in the physical activity(PA)guidelines.展开更多
Existing evidence suggests residential greenness is beneficial to human,while no research to date explored the associations of greenness with age-related macular degeneration(AMD).To evaluate the association of greenn...Existing evidence suggests residential greenness is beneficial to human,while no research to date explored the associations of greenness with age-related macular degeneration(AMD).To evaluate the association of greenness with AMD,modification and mediation effect of air pollution,we conducted this prospective study.We con-structed weighted quantile sum(WQS)index as co-exposure to nitrogen oxides(NO_(x)),particulate matter<2.5μm(PM_(2.5)),particulate matter<10μm(PM10).Stratified Cox regression models were applied to test the effect of exposure.Effect modification of air pollution was assessed.Stratified Cox models through the indirect method and Aalen additive risk models were used in mediation analysis.Over median follow-up of 11.67 years,4596 AMD events were ascertained.Hazard ratios(HRs)and 95%confidence intervals(95%CIs)of incident AMD for pollution per interquartile range(IQR)increment were 1.10(1.04–1.16)for nitrogen dioxide(NO_(2)),1.09(1.03–1.15)for NO_(x),1.14(1.05–1.24)for PM_(2.5),1.13(1.05–1.21)for PM10.The HR(95%CI)of AMD associated with greenness 1000 m buffer per IQR increment was 0.91(0.86–0.97),300 m buffer was 0.94(0.89–0.99).The as-sociation between greenness 1000 m and AMD was 28.59%,44.77%,35.59%,32.31%and 27.08%mediated by the decreased WQS index,NO_(2),NO_(x),PM_(2.5) and PM10,respectively.Increased greenness was associated with lower AMD incidence,and air pollution partly mediate it,which implies that interventions aimed at improving air quality and increasing greenness could have a dual benefit in mitigating AMD risk.展开更多
Background Physical frailty and depression may share common pathophysiological pathways associated with dementia and thus interact with each other.However,previous studies have primarily focused on the individual impa...Background Physical frailty and depression may share common pathophysiological pathways associated with dementia and thus interact with each other.However,previous studies have primarily focused on the individual impact of these factors on dementia.Aims To examine the joint effect and interaction of physical frailty and depression on the risk of all-cause dementia.Methods We conducted prospective analyses among participants aged≥60 years from three cohorts:the UK Biobank(UKB),the English Longitudinal Study of Ageing(ELSA)and the Health and Retirement Study(HRS).Physical frailty was assessed using modified versions of the Fried frailty phenotype.Depression was evaluated through mental health questionnaires or combined with hospital admission records.The primary outcome was incident all-cause dementia,identified via active follow-up and passive surveillance.Cox proportional hazards models were used to estimate the hazard ratios(HRs)and 95%confidence intervals(CIs).Results A total of 220947 participants(mean age:64.5 years;53.3%female)were included.Over 2832696 person-years of follow-up,9088 participants(7605 in UKB,1207 in HRS and 276 in ELSA)developed incident all-cause dementia.Compared with robust individuals,frail participants faced a 155%increased risk of dementia(pooled HR:2.55,95%CI 2.36 to 2.76;I2=72.3%).Depression conferred a 1.59-fold excess risk for dementia(pooled HR:1.59,95%CI 1.50 to 1.69;I2=56.8%).Adding physical frailty and depression to a traditional dementia risk model significantly improved prediction accuracy(all p-Δarea under the curve<0.05).Jointly,participants with both physical frailty and depression exhibited the highest dementia risk(pooled HR:3.23,95%CI 2.86 to 3.65;I2=41.6%)compared with those without physical frailty and depression.Moreover,a significant additive interaction between physical frailty and depression was observed(pooled relative excess risk due to interaction:0.38,95%CI 0.13 to 0.63),with 17.1%(95%CI 6.0%to 28.3%)of dementia risk attributed to their interactive effects.Conclusions Individuals with both physical frailty and depression had the highest risk of dementia.More importantly,these two factors interact in an additive manner,further amplifying dementia risk.展开更多
BACKGROUND Gastric cancer is one of the most common cancers worldwide,especially in East Asia.AIM To explore the clinical outcomes and progression-related factors of low-grade intraepithelial neoplasia(LGIN)in the gas...BACKGROUND Gastric cancer is one of the most common cancers worldwide,especially in East Asia.AIM To explore the clinical outcomes and progression-related factors of low-grade intraepithelial neoplasia(LGIN)in the gastric mucosa and provide valuable guidance for improving treatment efficacy.METHODS A total of 357 patients diagnosed with LGIN based on initial pathological examination in Anhui Provincial Hospital or three other medical consortium units between January 2022 and June 2024 were included.Among them,296 patients were followed up with endoscopic and biopsy pathology.Logistic regression was utilized to analyze the relevant risk factors for LGIN progression in the gastric mucosa.RESULTS The distribution sites of LGIN among the 357 patients were as follows:Gastric antrum(54.6%),gastric cardia(24.1%),gastric angulus(8.7%),gastric body(4.8%),gastric fundus(4.8%),and multiple sites(3.1%).Additionally,of the 357 patients with LGIN,112(31.4%)developed ulceration and 59(16.5%)experienced gastric polyps.Furthermore,231 of the 357(64.71%)patients with LGIN tested positive for Helicobacter pylori(H.pylori)infection.The H.pylori infection rates of the patients with LGIN with accompanying atrophy,intestinal metaplasia,and gastric ulcer were 51.95%,59.31%,and 28.57%,respectively.Multivariate logistic regression analysis showed that age≥60 years[odds ratio(OR)=3.063,95%confidence interval(CI):1.351-6.945,P=0.007],H.pylori infection(OR=3.560,95%CI:1.158-10.949,P=0.027),multiple locations(OR=10.136,95%CI:2.045-50.237,P=0.005),lesion size≥2 cm(OR=3.921,95%CI:1.664-9.237,P=0.002),and gastric ulcer(OR=2.730,95%CI:1.197-6.223,P=0.017)were predictive factors for LGIN progression.CONCLUSION LGIN progression is closely related to age,H.pylori positivity,multiple locations,lesion size≥2 cm,and gastric ulcer.Thus,actively identifying these risk factors in patients with LGIN may have certain clinical significance in preventing further tumor progression.展开更多
Background Cognitive decline is a significant concern for stroke survivors,affecting their quality of life and increasing their burden on the healthcare system.DL-3-n butylphthalide(butylphthalide)has shown efficacy i...Background Cognitive decline is a significant concern for stroke survivors,affecting their quality of life and increasing their burden on the healthcare system.DL-3-n butylphthalide(butylphthalide)has shown efficacy in the short-term treatment of various cognitive impairments.This study evaluated the efficacy of butylphthalide in preventing cognitive decline over a 12-month period in patients with ischaemic stroke.Methods This prospective following-up study involved patients newly diagnosed with ischaemic stroke between 1 month and 6 months after stroke onset and not in the acute phase.Patients were assigned to either the butylphthalide or control group.Cognitive function was assessed using the mini-mental state examination(MMSE)at baseline and at the 12-month follow-up.Statistical analyses included t-tests,χ2 tests and multivariate regression analyses.Results Butylphthalide was negatively associated with the MMSE D-value(β=−0.122;95%CI−1.932 to−0.298;p=0.003)and the MMSE D-value percentage(β=−0.117;95%CI−0.057 to−0.011;p=0.004).A multivariate analysis indicated that butylphthalide treatment was negatively associated with both changes in orientation and language score.Additionally,the incidence of cognitive decline was significantly lower in the butylphthalide group(OR,0.612;p=0.020)than the control group.An age of≥60 years and lower educational level were identified as risk factors for lower cognitive score and cognitive decline.Conclusion This study demonstrated that butylphthalide is effective in preventing cognitive decline in patients with ischaemic stroke.These findings have significant implications for clinical practice,suggesting that butylphthalide could be incorporated into standard post-stroke care regimens to improve patient outcomes and reduce the healthcare burden.Additional multicentre double-blind trials are recommended to confirm these results in diverse populations.展开更多
Purpose–This study summarizes the overall situation of the resources of the national science and technology innovation platform in the railway industry,including the distribution of platform types,supporting institut...Purpose–This study summarizes the overall situation of the resources of the national science and technology innovation platform in the railway industry,including the distribution of platform types,supporting institutions,construction sites,professional fields,etc.,to provide a reference for the further improvement and optimization of the national science and technology innovation platform system in the railway industry.Design/methodology/approach–Through literature review,field investigation,expert consultation and other methods,this paper systematically investigates and analyzes the development status of the national science and technology innovation platform in the railway industry.Findings–Taking the national science and technology innovation platform of the railway industry as the research object,this paper investigates and analyzes the construction,development and distribution of the national science and technology innovation platform of railway industry over the years.And the National Engineering Research Center of High-speed Railway and Urban Rail Transit System Technology was taken as an example to introduce its operation effect.Originality/value–China Railway has made great development achievements,with the construction and development of national science and technology innovation platform in the railway industry.In recent years,a large number of national science and technology innovation platforms have been built in the railway industry,which play an important role in railway technological innovation,standard setting and commodification,and Railway Sciences provide strong support for railway technology development.展开更多
BACKGROUND The atherogenic index of plasma(AIP)has been shown to be positively correlated with cardiovascular disease in previous studies.However,it is unclear whether elderly people with long-term high AIP levels are...BACKGROUND The atherogenic index of plasma(AIP)has been shown to be positively correlated with cardiovascular disease in previous studies.However,it is unclear whether elderly people with long-term high AIP levels are more likely to develop coronary heart disease(CHD).Therefore,the aim of this study was to investigate the relationship between AIP trajectory and CHD incidence in elderly people.METHODS 19,194 participants aged≥60 years who had three AIP measurements between 2018 and 2020 were included in this study.AIP was defined as log10(triglyceride/high-density lipoprotein cholesterol).The group-based trajectory model was used to identify different trajectory patterns of AIP from 2018 to 2020.Cox proportional hazards models were used to estimate the hazard ratio(HR)with 95%CI of CHD events between different trajectory groups from 2020 to 2023.RESULTS Three different trajectory patterns were identified through group-based trajectory model:the low-level group(n=7410,mean AIP:-0.25 to-0.17),the medium-level group(n=9981,mean AIP:0.02-0.08),and the high-level group(n=1803,mean AIP:0.38-0.42).During a mean follow-up of 2.65 years,a total of 1391 participants developed CHD.After adjusting for potential confounders,compared with the participants in the low-level group,the HR with 95%CI of the medium-level group and the high-level group were estimated to be 1.24(1.10-1.40)and 1.43(1.19-1.73),respectively.These findings remained consistent in subgroup analyses and sensitivity analyses.CONCLUSIONS There was a significant correlation between persistent high AIP level and increased CHD risk in the elderly.This suggests that monitoring the long-term changes in AIP is helpful to identify individuals at high CHD risk in elderly people.展开更多
Periprosthetic fracture of femur is a common and complex complication after joint replacement. With the increase of operation volume, its incidence is increasing year by year. The treatment of this fracture is affecte...Periprosthetic fracture of femur is a common and complex complication after joint replacement. With the increase of operation volume, its incidence is increasing year by year. The treatment of this fracture is affected by many factors, including fracture type, prosthesis stability, patient age and comorbidities, and individualized treatment strategy is needed. In recent years, the internal fixation technology and prosthetic revision technology have made significant progress in surgical treatment, such as locking steel plate, titanium cable and bridge combined internal fixation system and other new technologies have effectively improved the treatment effect. In addition, the application of new materials and 3D printing technology, as well as the optimization of multidisciplinary cooperation mode, also provide new ideas for the treatment of complex fractures. However, there are still some problems such as inaccurate diagnosis, difficult choice of treatment options and high incidence of postoperative complications. In the future, technological innovation, the introduction of artificial intelligence and big data, and the further development of personalized treatment will bring more possibilities to improve the prognosis and quality of life of patients. This study summarizes the relevant research results and prospects the future development direction, providing references for clinical practice and subsequent research.展开更多
BACKGROUND Stoma creation is a common procedure in colorectal cancer surgery,however,stoma-related complications remain a significant concern.AIM To investigate the incidence,types,and risk factors of stoma-related co...BACKGROUND Stoma creation is a common procedure in colorectal cancer surgery,however,stoma-related complications remain a significant concern.AIM To investigate the incidence,types,and risk factors of stoma-related complications in colorectal cancer patients who underwent stoma creation.METHODS Patients with stoma was prospectively recorded in the established stoma system.Data was collected from this stoma management system from November 2021 through May 2024.The rates of stoma-related complications were assessed,and potential risk factors were analyzed using univariate and multivariate logistic regression models.RESULTS A total of 734 patients were included in the analysis.The results showed that 12.3%of patients experienced stoma-related complications,with mucocutaneous separation,edema,and skin excoriation being the most common complications.The majority(90%)of complications were classified as grade 2 according to the Clavien-Dindo classification.Surgical factors,such as blood loss volume greater than 500 mL and open surgery,were significantly associated with stoma complications.Additionally,stoma features like location,shape,color,height,and edema were important factors in the association with complications.Body mass index over 30 kg/m²was also found to be a significant risk factor.CONCLUSION These findings highlight the need for a holistic approach to preventing and managing stoma complications,considering both patient-related and surgical factors.展开更多
Thefield of energy storage devices is primarily dominated by lithium-ion batteries(LIBs)due to their mature manufacturing processes and stable performance.However,immature lithium recovery technology cannot stop the co...Thefield of energy storage devices is primarily dominated by lithium-ion batteries(LIBs)due to their mature manufacturing processes and stable performance.However,immature lithium recovery technology cannot stop the continuous increase in the cost of LIBs.Along with the rapid development of electric transportation,it has become inevitable to trigger a new round of competition in alternative energy storage systems.Some monovalent rechargeable metal ion batteries(sodium ion batteries(SIBs)and potassium ion batteries(PIBs),etc.)and multi-valent rechargeable metal-ion batteries(magnesium ion batteries(MIBs),calcium ion batteries(CIBs),zinc ion batteries(ZIBs),and aluminum ion batteries(AIBs),etc.)are potential candidates,which can replace LIBs in some of the scenarios to alleviate the pressure on supply.The cathode material plays a crucial role in determining the battery capacity.Transition metal compounds dominated by layered transition metal oxides as key cathode materials for secondary batteries play an important role in the advancement of various battery energy storage systems.In summary,this manuscript aims to review and summarize the research progress on transition metal compounds used as cathodes in different metal ion batteries,with the aim of providing valuable guidance for the exploration and design of high-performance integrated battery systems.展开更多
Hydrogen energy has long been considered an ideal green energy,and in particular,developed with great enthusiasm in recent years[1].To utilize hydrogen energy,efficient hydrogen storage(H-storage)and transportation ar...Hydrogen energy has long been considered an ideal green energy,and in particular,developed with great enthusiasm in recent years[1].To utilize hydrogen energy,efficient hydrogen storage(H-storage)and transportation are necessary.Although great progress has been achieved in H-storage by using high-pressure cylinder up to 70 MPa.展开更多
The tourism industry is one of the largest and fastest-growing sectors in the global market.It contributes towards complete growth and development of a country by bringing numerous economic value and benefit and helpi...The tourism industry is one of the largest and fastest-growing sectors in the global market.It contributes towards complete growth and development of a country by bringing numerous economic value and benefit and helping in building country’s brand value,image and identity.Eritrea has huge tourism potential owing to its natural,historical and cultural endowments.However,the tourism industry in Eritrea is only in its nascent stage.This study,therefore,try to identify and examine the major challenges of sustainable tourism development and its prospects.Primary data were collected from interview with different Ministry of Tourism authorities,travel agencies and tour operators’managers and owners.Secondary data were retrieved from annual reports of international tourism organizations,Ministry of Tourism,the State of Eritrea and other documented sources including magazines and relevant research and papers.The research concludes that Eritrea has great potential for the development of tourism.However,the tourism growth is blocked by specific factors such as poor image,inadequate tourism infrastructural and technological facilities,absence of coordination among tourism stakeholders and lack of skilled man power.This study will assist policymakers to understand the present challenges of the tourism industry and provide necessary recommendations to adopt appropriate strategies and mechanisms.展开更多
Objective This study aimed to explore the association between body mass index(BMI)and mortality based on the 10-year population-based multicenter prospective study.Methods A general population-based multicenter prospe...Objective This study aimed to explore the association between body mass index(BMI)and mortality based on the 10-year population-based multicenter prospective study.Methods A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023.Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality.Stratified analyses were performed based on the individual characteristics of the participants.Results Overall,19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died.The underweight(<18.5 kg/m^(2))presented an increase in all-cause mortality(adjusted hazards ratio[aHR]=2.00,95%confidence interval[CI]:1.66–2.41),while overweight(≥24.0 to<28.0 kg/m^(2))and obesity(≥28.0 kg/m^(2))presented a decrease with an aHR of 0.61(95%CI:0.52–0.73)and 0.51(95%CI:0.37–0.70),respectively.Overweight(aHR=0.76,95%CI:0.67–0.86)and mild obesity(aHR=0.72,95%CI:0.59–0.87)had a positive impact on mortality in people older than 60 years.All-2 cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m(aHR=0.95,95%CI:0.92–0.98)and increased slightly above that value,indicating a U-shaped association.The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses.Conclusion This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years.Therefore,it is essential to consider age differences when formulating health and weight management strategies.展开更多
Tick studies in Malaysia have experienced a dynamic evolution characterized by periods of growth,stagnation,and the potential for revival.Beginning during the colonial era in the early 1900s,tick studies were primaril...Tick studies in Malaysia have experienced a dynamic evolution characterized by periods of growth,stagnation,and the potential for revival.Beginning during the colonial era in the early 1900s,tick studies were primarily conducted by European scientists and curators,establishing the foundation for tick taxonomy in the region.Pioneering works by George Henry Falknier Nuttall and Cecil Warburton introduced several new tick species,including Haemaphysalis(H.)calva,H.mjoebergi,H.vidua and H.wellingtoni[1].However,some records from this period are now considered doubtful,for instance Amblyomma(A.)breviscutatum,A.clypeolatum and A.integrum.The 1929 description of Ornithodoros batuensis by Stanley Hirst[2]marked the first documentation of a soft tick species in Malaysia,setting the stage for subsequent research endeavours.The Golden Age of tick studies(early 1950s-late 1980s)in Malaysia saw a surge in tick research activities.展开更多
ChatGPT technology based on large language models(LLM)shows great potential in improving the quality of medical care,assisting clinical decision making and optimizing patient communication.The role of ChatGPT in ophth...ChatGPT technology based on large language models(LLM)shows great potential in improving the quality of medical care,assisting clinical decision making and optimizing patient communication.The role of ChatGPT in ophthalmology is still in its infancy.This review aims to explore the application prospect of ChatGPT in ophthalmology.Relevant literature was reviewed and analyzed,and the application prospects of LLM represented by ChatGPT in ophthalmology were summarized,including clinical assisted diagnosis,patient education and communication,history collection and text writing,clinical research,and medical education,etc.At the same time,the challenges and solutions faced by ChatGPT in ophthalmology were pointed out.Its safety,efficacy and ethics remain controversial in practical applications.Therefore,it is necessary to strengthen the supervision and research on its application to ensure safety and effectiveness.In the future,with the development of technology,ChatGPT is expected to play a greater role in ophthalmology and enhance the medical experience.展开更多
基金supported by the National Natural Science Foundation of China(Grant Nos.52021005,52325904,and 51991391)。
文摘Geological prospecting and the identification of adverse geological features are essential in tunnel construction,providing critical information to ensure safety and guide engineering decisions.As tunnel projects extend into deeper and more mountainous terrains,engineers face increasingly complex geological conditions,including high water pressure,intense geo-stress,elevated geothermal gradients,and active fault zones.These conditions pose substantial risks such as high-pressure water inrush,largescale collapses,and tunnel boring machine(TBM)blockages.Addressing these challenges requires advanced detection technologies capable of long-distance,high-precision,and intelligent assessments of adverse geology.This paper presents a comprehensive review of recent advancements in tunnel geological ahead prospecting methods.It summarizes the fundamental principles,technical maturity,key challenges,development trends,and real-world applications of various detection techniques.Airborne and semi-airborne geophysical methods enable large-scale reconnaissance for initial surveys in complex terrain.Tunnel-and borehole-based approaches offer high-resolution detection during excavation,including seismic ahead prospecting(SAP),TBM rock-breaking source seismic methods,fulltime-domain tunnel induced polarization(TIP),borehole electrical resistivity,and ground penetrating radar(GPR).To address scenarios involving multiple,coexisting adverse geologies,intelligent inversion and geological identification methods have been developed based on multi-source data fusion and artificial intelligence(AI)techniques.Overall,these advances significantly improve detection range,resolution,and geological characterization capabilities.The methods demonstrate strong adaptability to complex environments and provide reliable subsurface information,supporting safer and more efficient tunnel construction.
文摘Rowlands et al.1present an analysis of accelerometer data from the UK Biobank cohort,examining variations in the duration,intensity,and accumulation of moderate-intensity physical activity(MPA)and vigorous-intensity physical activity(VPA)sufficient to reduce the risk of all-cause mortality.In this study,the authors questioned if shorter durations(i.e.,1,2,3,4,5,10,15,and 20 min/day)of MPA and VPA performed continuously or accumulated throughout the day would equally reduce the risks of all-cause mortality as longer duration MPA and VPA recommended in the physical activity(PA)guidelines.
基金supported by the High-level Talents Introduction Plan from Central South University(No.502045003)the National Natural Science Foundation of China(No.42277438)Hunan Provincial Natural Science Foundation for Distinguished Young Scholars(No.2024JJ2082)to Fang Xiao,and the Postgraduate Independent Exploration and Innovation Project of Central South University,China(Nos.2024ZZTS0557 and 2023ZZTS0993)。
文摘Existing evidence suggests residential greenness is beneficial to human,while no research to date explored the associations of greenness with age-related macular degeneration(AMD).To evaluate the association of greenness with AMD,modification and mediation effect of air pollution,we conducted this prospective study.We con-structed weighted quantile sum(WQS)index as co-exposure to nitrogen oxides(NO_(x)),particulate matter<2.5μm(PM_(2.5)),particulate matter<10μm(PM10).Stratified Cox regression models were applied to test the effect of exposure.Effect modification of air pollution was assessed.Stratified Cox models through the indirect method and Aalen additive risk models were used in mediation analysis.Over median follow-up of 11.67 years,4596 AMD events were ascertained.Hazard ratios(HRs)and 95%confidence intervals(95%CIs)of incident AMD for pollution per interquartile range(IQR)increment were 1.10(1.04–1.16)for nitrogen dioxide(NO_(2)),1.09(1.03–1.15)for NO_(x),1.14(1.05–1.24)for PM_(2.5),1.13(1.05–1.21)for PM10.The HR(95%CI)of AMD associated with greenness 1000 m buffer per IQR increment was 0.91(0.86–0.97),300 m buffer was 0.94(0.89–0.99).The as-sociation between greenness 1000 m and AMD was 28.59%,44.77%,35.59%,32.31%and 27.08%mediated by the decreased WQS index,NO_(2),NO_(x),PM_(2.5) and PM10,respectively.Increased greenness was associated with lower AMD incidence,and air pollution partly mediate it,which implies that interventions aimed at improving air quality and increasing greenness could have a dual benefit in mitigating AMD risk.
基金supported by the National Key Research and Development Program of China(2017YFC0907004 to YZ)。
文摘Background Physical frailty and depression may share common pathophysiological pathways associated with dementia and thus interact with each other.However,previous studies have primarily focused on the individual impact of these factors on dementia.Aims To examine the joint effect and interaction of physical frailty and depression on the risk of all-cause dementia.Methods We conducted prospective analyses among participants aged≥60 years from three cohorts:the UK Biobank(UKB),the English Longitudinal Study of Ageing(ELSA)and the Health and Retirement Study(HRS).Physical frailty was assessed using modified versions of the Fried frailty phenotype.Depression was evaluated through mental health questionnaires or combined with hospital admission records.The primary outcome was incident all-cause dementia,identified via active follow-up and passive surveillance.Cox proportional hazards models were used to estimate the hazard ratios(HRs)and 95%confidence intervals(CIs).Results A total of 220947 participants(mean age:64.5 years;53.3%female)were included.Over 2832696 person-years of follow-up,9088 participants(7605 in UKB,1207 in HRS and 276 in ELSA)developed incident all-cause dementia.Compared with robust individuals,frail participants faced a 155%increased risk of dementia(pooled HR:2.55,95%CI 2.36 to 2.76;I2=72.3%).Depression conferred a 1.59-fold excess risk for dementia(pooled HR:1.59,95%CI 1.50 to 1.69;I2=56.8%).Adding physical frailty and depression to a traditional dementia risk model significantly improved prediction accuracy(all p-Δarea under the curve<0.05).Jointly,participants with both physical frailty and depression exhibited the highest dementia risk(pooled HR:3.23,95%CI 2.86 to 3.65;I2=41.6%)compared with those without physical frailty and depression.Moreover,a significant additive interaction between physical frailty and depression was observed(pooled relative excess risk due to interaction:0.38,95%CI 0.13 to 0.63),with 17.1%(95%CI 6.0%to 28.3%)of dementia risk attributed to their interactive effects.Conclusions Individuals with both physical frailty and depression had the highest risk of dementia.More importantly,these two factors interact in an additive manner,further amplifying dementia risk.
基金the Research Project of the Chinese Digestive Early Cancer Physicians’Joint Growth Program,No.GTCZ-2021-AH-34-0012.
文摘BACKGROUND Gastric cancer is one of the most common cancers worldwide,especially in East Asia.AIM To explore the clinical outcomes and progression-related factors of low-grade intraepithelial neoplasia(LGIN)in the gastric mucosa and provide valuable guidance for improving treatment efficacy.METHODS A total of 357 patients diagnosed with LGIN based on initial pathological examination in Anhui Provincial Hospital or three other medical consortium units between January 2022 and June 2024 were included.Among them,296 patients were followed up with endoscopic and biopsy pathology.Logistic regression was utilized to analyze the relevant risk factors for LGIN progression in the gastric mucosa.RESULTS The distribution sites of LGIN among the 357 patients were as follows:Gastric antrum(54.6%),gastric cardia(24.1%),gastric angulus(8.7%),gastric body(4.8%),gastric fundus(4.8%),and multiple sites(3.1%).Additionally,of the 357 patients with LGIN,112(31.4%)developed ulceration and 59(16.5%)experienced gastric polyps.Furthermore,231 of the 357(64.71%)patients with LGIN tested positive for Helicobacter pylori(H.pylori)infection.The H.pylori infection rates of the patients with LGIN with accompanying atrophy,intestinal metaplasia,and gastric ulcer were 51.95%,59.31%,and 28.57%,respectively.Multivariate logistic regression analysis showed that age≥60 years[odds ratio(OR)=3.063,95%confidence interval(CI):1.351-6.945,P=0.007],H.pylori infection(OR=3.560,95%CI:1.158-10.949,P=0.027),multiple locations(OR=10.136,95%CI:2.045-50.237,P=0.005),lesion size≥2 cm(OR=3.921,95%CI:1.664-9.237,P=0.002),and gastric ulcer(OR=2.730,95%CI:1.197-6.223,P=0.017)were predictive factors for LGIN progression.CONCLUSION LGIN progression is closely related to age,H.pylori positivity,multiple locations,lesion size≥2 cm,and gastric ulcer.Thus,actively identifying these risk factors in patients with LGIN may have certain clinical significance in preventing further tumor progression.
基金funded by Tianjin Municipal Health Commission(TJWJ2023QN115)。
文摘Background Cognitive decline is a significant concern for stroke survivors,affecting their quality of life and increasing their burden on the healthcare system.DL-3-n butylphthalide(butylphthalide)has shown efficacy in the short-term treatment of various cognitive impairments.This study evaluated the efficacy of butylphthalide in preventing cognitive decline over a 12-month period in patients with ischaemic stroke.Methods This prospective following-up study involved patients newly diagnosed with ischaemic stroke between 1 month and 6 months after stroke onset and not in the acute phase.Patients were assigned to either the butylphthalide or control group.Cognitive function was assessed using the mini-mental state examination(MMSE)at baseline and at the 12-month follow-up.Statistical analyses included t-tests,χ2 tests and multivariate regression analyses.Results Butylphthalide was negatively associated with the MMSE D-value(β=−0.122;95%CI−1.932 to−0.298;p=0.003)and the MMSE D-value percentage(β=−0.117;95%CI−0.057 to−0.011;p=0.004).A multivariate analysis indicated that butylphthalide treatment was negatively associated with both changes in orientation and language score.Additionally,the incidence of cognitive decline was significantly lower in the butylphthalide group(OR,0.612;p=0.020)than the control group.An age of≥60 years and lower educational level were identified as risk factors for lower cognitive score and cognitive decline.Conclusion This study demonstrated that butylphthalide is effective in preventing cognitive decline in patients with ischaemic stroke.These findings have significant implications for clinical practice,suggesting that butylphthalide could be incorporated into standard post-stroke care regimens to improve patient outcomes and reduce the healthcare burden.Additional multicentre double-blind trials are recommended to confirm these results in diverse populations.
文摘Purpose–This study summarizes the overall situation of the resources of the national science and technology innovation platform in the railway industry,including the distribution of platform types,supporting institutions,construction sites,professional fields,etc.,to provide a reference for the further improvement and optimization of the national science and technology innovation platform system in the railway industry.Design/methodology/approach–Through literature review,field investigation,expert consultation and other methods,this paper systematically investigates and analyzes the development status of the national science and technology innovation platform in the railway industry.Findings–Taking the national science and technology innovation platform of the railway industry as the research object,this paper investigates and analyzes the construction,development and distribution of the national science and technology innovation platform of railway industry over the years.And the National Engineering Research Center of High-speed Railway and Urban Rail Transit System Technology was taken as an example to introduce its operation effect.Originality/value–China Railway has made great development achievements,with the construction and development of national science and technology innovation platform in the railway industry.In recent years,a large number of national science and technology innovation platforms have been built in the railway industry,which play an important role in railway technological innovation,standard setting and commodification,and Railway Sciences provide strong support for railway technology development.
基金supported by the National Key Research and Development Program of China(2017YFC1307705).
文摘BACKGROUND The atherogenic index of plasma(AIP)has been shown to be positively correlated with cardiovascular disease in previous studies.However,it is unclear whether elderly people with long-term high AIP levels are more likely to develop coronary heart disease(CHD).Therefore,the aim of this study was to investigate the relationship between AIP trajectory and CHD incidence in elderly people.METHODS 19,194 participants aged≥60 years who had three AIP measurements between 2018 and 2020 were included in this study.AIP was defined as log10(triglyceride/high-density lipoprotein cholesterol).The group-based trajectory model was used to identify different trajectory patterns of AIP from 2018 to 2020.Cox proportional hazards models were used to estimate the hazard ratio(HR)with 95%CI of CHD events between different trajectory groups from 2020 to 2023.RESULTS Three different trajectory patterns were identified through group-based trajectory model:the low-level group(n=7410,mean AIP:-0.25 to-0.17),the medium-level group(n=9981,mean AIP:0.02-0.08),and the high-level group(n=1803,mean AIP:0.38-0.42).During a mean follow-up of 2.65 years,a total of 1391 participants developed CHD.After adjusting for potential confounders,compared with the participants in the low-level group,the HR with 95%CI of the medium-level group and the high-level group were estimated to be 1.24(1.10-1.40)and 1.43(1.19-1.73),respectively.These findings remained consistent in subgroup analyses and sensitivity analyses.CONCLUSIONS There was a significant correlation between persistent high AIP level and increased CHD risk in the elderly.This suggests that monitoring the long-term changes in AIP is helpful to identify individuals at high CHD risk in elderly people.
文摘Periprosthetic fracture of femur is a common and complex complication after joint replacement. With the increase of operation volume, its incidence is increasing year by year. The treatment of this fracture is affected by many factors, including fracture type, prosthesis stability, patient age and comorbidities, and individualized treatment strategy is needed. In recent years, the internal fixation technology and prosthetic revision technology have made significant progress in surgical treatment, such as locking steel plate, titanium cable and bridge combined internal fixation system and other new technologies have effectively improved the treatment effect. In addition, the application of new materials and 3D printing technology, as well as the optimization of multidisciplinary cooperation mode, also provide new ideas for the treatment of complex fractures. However, there are still some problems such as inaccurate diagnosis, difficult choice of treatment options and high incidence of postoperative complications. In the future, technological innovation, the introduction of artificial intelligence and big data, and the further development of personalized treatment will bring more possibilities to improve the prognosis and quality of life of patients. This study summarizes the relevant research results and prospects the future development direction, providing references for clinical practice and subsequent research.
基金Beijing Municipal Administration of Hospitals Incubating Program,No.PZ20200272018 Beijing Talent Incubating Funding,No.2018-4+3 种基金National Natural Science Foundation of China,No.81773214Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support,No.ZYLX202116the National Key R&D Program of China,No.2021YFF1201104Science Foundation of Peking University Cancer Hospital-2023,No.JC202310.
文摘BACKGROUND Stoma creation is a common procedure in colorectal cancer surgery,however,stoma-related complications remain a significant concern.AIM To investigate the incidence,types,and risk factors of stoma-related complications in colorectal cancer patients who underwent stoma creation.METHODS Patients with stoma was prospectively recorded in the established stoma system.Data was collected from this stoma management system from November 2021 through May 2024.The rates of stoma-related complications were assessed,and potential risk factors were analyzed using univariate and multivariate logistic regression models.RESULTS A total of 734 patients were included in the analysis.The results showed that 12.3%of patients experienced stoma-related complications,with mucocutaneous separation,edema,and skin excoriation being the most common complications.The majority(90%)of complications were classified as grade 2 according to the Clavien-Dindo classification.Surgical factors,such as blood loss volume greater than 500 mL and open surgery,were significantly associated with stoma complications.Additionally,stoma features like location,shape,color,height,and edema were important factors in the association with complications.Body mass index over 30 kg/m²was also found to be a significant risk factor.CONCLUSION These findings highlight the need for a holistic approach to preventing and managing stoma complications,considering both patient-related and surgical factors.
基金support from the Nuclear Fuel Pellet Appearance Quality Inspection Device Project(20190304 A).
文摘Thefield of energy storage devices is primarily dominated by lithium-ion batteries(LIBs)due to their mature manufacturing processes and stable performance.However,immature lithium recovery technology cannot stop the continuous increase in the cost of LIBs.Along with the rapid development of electric transportation,it has become inevitable to trigger a new round of competition in alternative energy storage systems.Some monovalent rechargeable metal ion batteries(sodium ion batteries(SIBs)and potassium ion batteries(PIBs),etc.)and multi-valent rechargeable metal-ion batteries(magnesium ion batteries(MIBs),calcium ion batteries(CIBs),zinc ion batteries(ZIBs),and aluminum ion batteries(AIBs),etc.)are potential candidates,which can replace LIBs in some of the scenarios to alleviate the pressure on supply.The cathode material plays a crucial role in determining the battery capacity.Transition metal compounds dominated by layered transition metal oxides as key cathode materials for secondary batteries play an important role in the advancement of various battery energy storage systems.In summary,this manuscript aims to review and summarize the research progress on transition metal compounds used as cathodes in different metal ion batteries,with the aim of providing valuable guidance for the exploration and design of high-performance integrated battery systems.
文摘Hydrogen energy has long been considered an ideal green energy,and in particular,developed with great enthusiasm in recent years[1].To utilize hydrogen energy,efficient hydrogen storage(H-storage)and transportation are necessary.Although great progress has been achieved in H-storage by using high-pressure cylinder up to 70 MPa.
文摘The tourism industry is one of the largest and fastest-growing sectors in the global market.It contributes towards complete growth and development of a country by bringing numerous economic value and benefit and helping in building country’s brand value,image and identity.Eritrea has huge tourism potential owing to its natural,historical and cultural endowments.However,the tourism industry in Eritrea is only in its nascent stage.This study,therefore,try to identify and examine the major challenges of sustainable tourism development and its prospects.Primary data were collected from interview with different Ministry of Tourism authorities,travel agencies and tour operators’managers and owners.Secondary data were retrieved from annual reports of international tourism organizations,Ministry of Tourism,the State of Eritrea and other documented sources including magazines and relevant research and papers.The research concludes that Eritrea has great potential for the development of tourism.However,the tourism growth is blocked by specific factors such as poor image,inadequate tourism infrastructural and technological facilities,absence of coordination among tourism stakeholders and lack of skilled man power.This study will assist policymakers to understand the present challenges of the tourism industry and provide necessary recommendations to adopt appropriate strategies and mechanisms.
基金supported by the CAMS Innovation Fund for Medical Sciences(CIFMS)[grant number 2021-I2M-1-037]the National Natural Science Foundation of China[grant numbers 82373647,and 82473697].
文摘Objective This study aimed to explore the association between body mass index(BMI)and mortality based on the 10-year population-based multicenter prospective study.Methods A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023.Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality.Stratified analyses were performed based on the individual characteristics of the participants.Results Overall,19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died.The underweight(<18.5 kg/m^(2))presented an increase in all-cause mortality(adjusted hazards ratio[aHR]=2.00,95%confidence interval[CI]:1.66–2.41),while overweight(≥24.0 to<28.0 kg/m^(2))and obesity(≥28.0 kg/m^(2))presented a decrease with an aHR of 0.61(95%CI:0.52–0.73)and 0.51(95%CI:0.37–0.70),respectively.Overweight(aHR=0.76,95%CI:0.67–0.86)and mild obesity(aHR=0.72,95%CI:0.59–0.87)had a positive impact on mortality in people older than 60 years.All-2 cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m(aHR=0.95,95%CI:0.92–0.98)and increased slightly above that value,indicating a U-shaped association.The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses.Conclusion This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years.Therefore,it is essential to consider age differences when formulating health and weight management strategies.
基金supported by the Higher Institution Centre of Excellence(HICoE)program(MO002-2019&TIDREC-2023)funded by the Bernhard Nocht Institute for Tropical Medicine,Hamburg,Germany[100-TNCPI/INT 16/6/2(005/2020)].
文摘Tick studies in Malaysia have experienced a dynamic evolution characterized by periods of growth,stagnation,and the potential for revival.Beginning during the colonial era in the early 1900s,tick studies were primarily conducted by European scientists and curators,establishing the foundation for tick taxonomy in the region.Pioneering works by George Henry Falknier Nuttall and Cecil Warburton introduced several new tick species,including Haemaphysalis(H.)calva,H.mjoebergi,H.vidua and H.wellingtoni[1].However,some records from this period are now considered doubtful,for instance Amblyomma(A.)breviscutatum,A.clypeolatum and A.integrum.The 1929 description of Ornithodoros batuensis by Stanley Hirst[2]marked the first documentation of a soft tick species in Malaysia,setting the stage for subsequent research endeavours.The Golden Age of tick studies(early 1950s-late 1980s)in Malaysia saw a surge in tick research activities.
基金Supported by the Hainan Provincial Natural Science Foundation of China(No.825RC898)and Hainan Province Clinical Medical Center.
文摘ChatGPT technology based on large language models(LLM)shows great potential in improving the quality of medical care,assisting clinical decision making and optimizing patient communication.The role of ChatGPT in ophthalmology is still in its infancy.This review aims to explore the application prospect of ChatGPT in ophthalmology.Relevant literature was reviewed and analyzed,and the application prospects of LLM represented by ChatGPT in ophthalmology were summarized,including clinical assisted diagnosis,patient education and communication,history collection and text writing,clinical research,and medical education,etc.At the same time,the challenges and solutions faced by ChatGPT in ophthalmology were pointed out.Its safety,efficacy and ethics remain controversial in practical applications.Therefore,it is necessary to strengthen the supervision and research on its application to ensure safety and effectiveness.In the future,with the development of technology,ChatGPT is expected to play a greater role in ophthalmology and enhance the medical experience.
