This systematic review synthesizes empirical research on external risk factors for adolescent smartphone addiction.Scopus and Web of Science were searched for English peer-reviewed empirical articles from 2008 onward;...This systematic review synthesizes empirical research on external risk factors for adolescent smartphone addiction.Scopus and Web of Science were searched for English peer-reviewed empirical articles from 2008 onward;28 met inclusion criteria(excluding non-adolescents,generic internet addiction,non-empirical work,or non-English).Thematic synthesis organized findings into three external risk domains—family,school,and peers—considering cultural/contextual mechanisms.Family dynamics(parental phubbing,harsh parenting,dysfunction),school stressors,and adverse peer relationships were identified as accumulating,direct and indirect contributors to smartphone addiction.These operate within a techno-ecological framework,where digital technologies amplify vulnerabilities and create new pathways for maladaptive use.Evidence favors an ecological,multi-level perspective.Future research should use longitudinal designs,standardize measures across cultures,and examine understudied regions—especially Africa—to guide culturally sensitive interventions.展开更多
Background:Medical artificial intelligence(MAI)is a synthesis of medical science and artificial intelligence development,serving as a crucial field in the current advancement and application of AI.In the process of de...Background:Medical artificial intelligence(MAI)is a synthesis of medical science and artificial intelligence development,serving as a crucial field in the current advancement and application of AI.In the process of developing medical AI,there may arise not only legal risks such as infringement of privacy rights and health rights but also ethical risks stemming from violations of the principles of beneficence and non-maleficence.Methods:To effectively address the damages caused by MAI in the future,it is necessary to establish a hierarchical governance system with MAI.This paper examines the systematic collection of local practices in China and the induction and integration of legal remedies for the damage of MAI.Results:To effectively address the ethical and legal challenges of medical artificial intelligence,a hierarchical regulatory system should be established,which based on the impact of intervention measures on natural rights and differences in intervention timing.This paper finally obtains a legal hierarchical governance system corresponding to the ethical risks and legal risks of MAI in China.Conclusion:The Chinese government has formed a multi-agent governance system based on the impact of risks on rights and the timing of legal intervention,which provides a reference for other countries to follow up on the research on MAI risk management.展开更多
Antibiotics are widespread in aquatic environments due to their extensive use in human healthcare and ani-mal husbandry.However,research on the occurrence and bioaccumulation of antibiotics in aquatic organisms within...Antibiotics are widespread in aquatic environments due to their extensive use in human healthcare and ani-mal husbandry.However,research on the occurrence and bioaccumulation of antibiotics in aquatic organisms within shallow wetland lakes remains limited.This study investigated the occurrence and bioaccumulation of ten commonly used antibiotics in the Baiyang Lake,northern China’s largest shallow wetland lake.The results indicated that sulfonamides and fluoroquinolones were the predominant antibiotics in surface water,whereas fluoroquinolones and macrolides were more prevalent in sediment.Fluoroquinolones demonstrated significant potential for bioaccumulation in targeted aquatic organisms,including both animals and plants(Carassius au-ratus and Phragmites australis).The bioaccumulation of antibiotics in Carassius auratus was correlated with their solubility,whereas in Phragmites australis,this was associated with their octanol-water partition coefficients and molecular weights.Ecological risk assessment indicated that most antibiotics posed minimal to low risk levels.However,four antibiotics were exceptions:clarithromycin(12.5%)and sulfamethoxazole(6.25%)presented a high risk in surface water samples,while norfloxacin(25.0%)and ciprofloxacin(25.0%)posed a high risk in sediment samples.Norfloxacin,ciprofloxacin,and roxithromycin were identified as key indicator antibiotics for enhancing the local monitoring and control of antibiotic contamination based on four criteria:(1)high con-centrations,(2)frequent detection,(3)capacity for bioaccumulation,and(4)ecological risk levels.This study contributes to a deeper understanding of the status of antibiotic contamination,bioaccumulation characteristics,and ecological risk in Baiyang Lake,thereby supporting efforts to monitor and regulate antibiotic pollution.展开更多
Flood risk in South Africa remains a problem due to climate change,rapid urbanisation and persistent disparities in the region and low-income urban households are disproportionately impacted because of poor access to ...Flood risk in South Africa remains a problem due to climate change,rapid urbanisation and persistent disparities in the region and low-income urban households are disproportionately impacted because of poor access to affordable flood insurance.This paper constructs the Integrated Market Flood Risk Insurance Framework(IMFRIF)based on a qualitative,desk-based research design consisting of contextual policy analysis,systematic literature review and analytical synthesis through systems thinking.The policy and document analysis reviewed the legislation on national disaster management,insurance and industry reports to determine institutional and market limitations on the provision of flood insurance.A PRISMA-ScR systematic literature review filtered 312 records on Scopus,Web of Science,and Google Scholar,which led to the identification of 47 peer-reviewed articles and 15 policy and comparative case studies.Thematic analysis led to the identification of six prevail-ing clusters of barriers based on the influence on insurance uptake,which included affordability and product design,trust and risk perception,data and risk assessment gaps,regulatory capacity,multi-stakeholder coordi-nation,and community engagement.The results of these studies were used to design the IMFRIF,a system incorporating 9 major stakeholder groups and 5 interdependent system components into a single market-based design.The framework provides a systematic foundation to the resolution of systemic exclusion of flood insur-ance,but specifically acknowledges the implementation limitations regarding data availability,regulation ca-pacity,fiscal sustainability and communal level of trust.The IMFRIF is placed as a progressive and responsive system that offers a point of future empirical confirmation and policy implementation to promote inclusive disaster risk financing in South Africa and comparable low-and middle-income contexts.展开更多
Objective:To evaluate the cost-effectiveness of annual trivalent inactivated influenza vaccine(IIV3)under the context of Zhejiang province.Methods:A state transition simulation model was constructed to estimate the he...Objective:To evaluate the cost-effectiveness of annual trivalent inactivated influenza vaccine(IIV3)under the context of Zhejiang province.Methods:A state transition simulation model was constructed to estimate the health and economic outcomes of IIV3 vaccination program compared to no vaccination for hypothetical cohorts of Zhejiang province stratified by age and risk status.Model input parameters were chosen based on published literatures and expert advices.The analysis used societal perspectives and a one-year time horizon,and permanent outcomes were also included.The primary outcome was the incremental cost-effectiveness ratio(ICER),with expression of US dollars per quality adjusted life years(QALYs)gained.Results:In subgroups not at high risk for influenza-related complications(non-high risk subgroup),ICER ranged from $6268/QALY(for adults aged 50-64 years)to $11260/QALY(for children aged from 6 months to 4 years).In subgroups at high risk for influenza-related complications(high risk subgroup),ICER ranged from cost-saving(adults aged≥65 years)to $5260/QALY(for children aged from 6 months to 4 years).ICER were most sensitive to changes in probability of influenza illness,cost of hospitalization,and probability of death for adults aged 18-49 years with non-high risk status.Conclusions:ICERs of annual influenza vaccination varied by age and risk status but were less than the Gross Domestic Product(GDP)per capita of Zhejiang province($17745 in 2023),which remained cost-effective for all-age and different risk status groups from a societal perspective.展开更多
Objective:We assessed the risk for physical inactivity due to inadequate health literacy using multivariable analysis in a large middleaged population.Methods:This cross-sectional mail survey using a self-administered...Objective:We assessed the risk for physical inactivity due to inadequate health literacy using multivariable analysis in a large middleaged population.Methods:This cross-sectional mail survey using a self-administered questionnaire was conducted in 2020 and included 33,902 community residents aged 40-64 years from 5 cities in Osaka Prefecture,Japan.Of these,12,446(36.7%)agreed to participate in the survey.After exclusion of those with regular visits to medical institutions and those with missing data,the analysis included 3742 participants.Health literacy was measured by the communicative and critical health literacy(CCHL)scale,and participants were classified into 3 groups(low,medium,and high health literacy groups)by the tertiles of the CCHL scale score.Physical inactivity was defined as not completing at least 150 min of moderate-intensity physical activity throughout the week.Results:After adjustment for age,gender,education level,occupation,economic status,living alone,and stages of health behavior change,the multivariable-adjusted odds ratios(ORs)for physical inactivity were 1.36(95% confidence interval[CI]:1.16-1.59,P<0.001)in the medium health literacy group and 1.70(95%CI:1.36-2.11,P<0.001)in the low health literacy group compared with the high health literacy group.Conclusions:This large-scale study provides compelling evidence that those with inadequate health literacy are at higher risk for physical inactivity among middle-aged adults.展开更多
Purpose-This study explores how managerial leadership and organizational innovation interact to enhance resilience and risk management in railway supply chains and how these capabilities contribute to sustained compet...Purpose-This study explores how managerial leadership and organizational innovation interact to enhance resilience and risk management in railway supply chains and how these capabilities contribute to sustained competitive advantage.It emphasizes the strategic importance of resilience in railway systems that face operational complexity,regulatory pressures and increasing exposure to systemic risks.Design/methodology/approach-A mixed-methods design was employed,integrating survey data from 186 railway organizations with six case studies involving railway operators,rolling stock manufacturers and supply chain partners across multiple regions.Constructs were measured using validated scales and hypothesized relationships were tested using Structural Equation Modeling(SEM).Case study interviews were analyzed thematically to provide contextual understanding of leadership practices and innovation strategies.Findings-The results confirm that transformational managerial leadership significantly predicts innovation adoption,which in turn strengthens resilience and risk management capabilities.Resilience emerged as a powerful driver of competitive advantage,reinforcing its role as a strategic capability rather than a reactive response to disruptions.Furthermore,innovation was shown to partially mediate the relationship between leadership and resilience,highlighting its function as the operational channel through which vision translates into capability.Originality/value-This study contributes to the literature by integrating the Resource-Based View(RBV)and Dynamic Capabilities(DC)framework into the context of railway supply chains.It is among the first to empirically validate the mediating role of innovation between leadership and resilience,offering both theoretical advancements and actionable strategies for building resilient and competitive railway systems.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
Objectives This study aimed to explore the lagged and cumulative effects of risk factors on disability in older adults using distributed lag non-linear models(DLNMs).Methods We utilized data from the China Health and ...Objectives This study aimed to explore the lagged and cumulative effects of risk factors on disability in older adults using distributed lag non-linear models(DLNMs).Methods We utilized data from the China Health and Retirement Longitudinal Study(CHARLS).After feature selection via Elastic Net Regularization,we applied DLNMs to evaluate the lagged effects of risk factors.Disability was defined as the presence of any difficulties in basic activities of daily living(BADL).The cumulative relative risk(CRR)was calculated by summing the lag-specific risk estimates,representing the cumulative disability risk over the specified lag period.Effect modifications and sensitivity analyses were also performed.Results This study included a total of 2,318 participants.Early-phase lag factors,such as the difficulty in stooping(CRR=3.58;95%CI:2.31-5.55;P<0.001)and walking(CRR=2.77;95%CI:1.39-5.55;P<0.001),exerted the strongest effects immediately upon occurrence.Mid-phase lag factors,such as arthritis(CRR=1.51;95%CI:1.10-2.06;P=0.001),showed a resurgence in disability risk within 2-3 years.Late-phase lag factors,including depressive symptoms(CRR=2.38;95%CI:1.30-4.35;P<0.001)and elevated systolic blood pressure(CRR=1.64;95%CI:1.06-2.79;P=0.02),exhibited significant long-term cumulative risks.Conversely,grip strength(CRR=0.80;95%CI:0.54-0.95;P=0.02)and social participation(CRR=0.89;95%CI:0.73-0.99;P=0.04)were significant protective factors.Conclusions The findings underscore the importance of tailored interventions that account for various lag characteristics of different factors to effectively mitigate disability risk.Future studies should explore the underlying biological and sociological mechanisms of these lagged effects,identify intervention strategies that target risk factors with different lagged patterns,and evaluate their effectiveness.展开更多
As one of the main chronic diseases in modern society,coronary heart disease,as a major disease that affects people’s lives and health,has the characteristics of hidden onset and sudden onset.Coronary heart disease h...As one of the main chronic diseases in modern society,coronary heart disease,as a major disease that affects people’s lives and health,has the characteristics of hidden onset and sudden onset.Coronary heart disease has relatively clear risk factors.Among them,blood lipid levels and blood sugar levels,as two main risk factors,play an important role in promoting the onset of coronary heart disease.The two complement each other in a vicious cycle,synergize and promote each other,promote the process of coronary atherosclerosis,thereby causing coronary heart disease.Multiple components in blood lipids and poor management of long-term blood sugar levels play a major role in specific clinical problems.This article reviews the different components of blood lipids and the effects of hyperglycemia on coronary heart disease,and initially expounds the mechanism by which blood lipids and blood sugar levels synergize each other to aggravate the risk of coronary heart disease,and combines them with relevant clinical issues,in order to help clinicians guide the prevention of coronary heart disease in terms of blood lipids and blood sugar levels.展开更多
Debris flow events are frequent in Tajikistan,yet comprehensive investigations at the regional scale are limited.This study integrates remote sensing,Geographic Information System,and machine learning techniques to ev...Debris flow events are frequent in Tajikistan,yet comprehensive investigations at the regional scale are limited.This study integrates remote sensing,Geographic Information System,and machine learning techniques to evaluate debris flow susceptibility and associated hazards across Tajikistan.A dataset comprising 405 documented debris flow points and 14 influencing factors,encompassing geological,climatic-hydrological,and anthropogenic variables,was established.Three machine learning algorithms—Random Forest,Support Vector Machine(SVM),and Multi-layer Perceptron—were applied to generate susceptibility maps and delineate debris flow risk zones.The results indicate that the areas of higher and high susceptibility accounted for 20.43%and 4.41%of the national area,respectively,and were predominantly concentrated along the Zeravshan and Vakhsh river basins.Among the evaluated models,SVM model demonstrated the highest predictive performance.Beyond conventional topographic and environmental controls,drought conditions were identified as a critical factor influencing debris flow occurrence within the arid and semi-arid mountainous regions of Tajikistan.These findings provide a scientific basis for regional debris flow risk management and disaster mitigation planning,and offer practical guidance for selecting conditioning factors in machine-learning-based susceptibility assessments in other dry mountainous environments.展开更多
Objective:To investigate the related factors of motility after total hip arthroplasty(THA).Methods:The convenience sampling method was used to include 213 patients receiving THA in our hospital from June 2020 to June ...Objective:To investigate the related factors of motility after total hip arthroplasty(THA).Methods:The convenience sampling method was used to include 213 patients receiving THA in our hospital from June 2020 to June 2023.They were divided into 2 groups according to the occurrence of kinesiophobia after THA.The demographic data of the 2 groups were analyzed by single-factor analysis.The factors with statistically significant differences were analyzed by binary logistic regression as independent variables.Finally,Spearman analysis was used to analyze the relationship between risk factors and the degree of kinesiophobia.Results:Among 213 THA patients,38 patients were diagnosed with kinetophobia,and the incidence of kinetophobia was 17.84%.visual analogue scale(VAS)and pain duration before operation were higher in patients with kinetophobia than in patients without kinetophobia.The scores of education level,self-efficacy,and social support were significantly lower than those of the non-phobia group,with statistical significance(P<0.05).Logistic regression analysis showed that VAS was a risk factor for kinetophobia after THA.Education level and self-efficacy were protective factors to reduce the occurrence of kinetophobia after THA(P<0.05).Spearman correlation analysis showed that the degree of pain(r=0.697,P<0.001)was positively correlated with the degree of kinetophobia,while the degree of education(r=-0.647,P<0.001)and self-efficacy(r=-0.756,P<0.001)were negatively correlated with the degree of kinetophobia.Conclusions:The degree of pain is a risk factor of kinesiophobia after THA,and it is positively correlated with the degree.Educational level and self-efficacy were protective factors to reduce the incidence of kinesiophobia and were negatively correlated with the degree of kinesiophobia.展开更多
Excessive levels of Fluoride(F−)and Cadmium(Cd)in drinking groundwater may pose health risks.This study assessed the health risks associated with F−and Cd contamination in rural drinking groundwater sources in Wutai C...Excessive levels of Fluoride(F−)and Cadmium(Cd)in drinking groundwater may pose health risks.This study assessed the health risks associated with F−and Cd contamination in rural drinking groundwater sources in Wutai County,Shanxi Province,China,to support population health protection,water resource management,and environmental decision-making.Groundwater samples were collected and analyzed,and a Human Health Risk Model(HHRA)was applied to evaluate groundwater quality.The results showed that both contents of F−and Cd in groundwater exceeded the Class III limits of China's national groundwater quality standard(GB/T 14848—2024).Fluoride levels met the Class V threshold,with enrichment area mainly located in the east part of the study area.Cadmium levels reached Class IV,with elevated concentrations primarily observed in the western and northwestern regions.Correlation analysis revealed that F−showed weak or no correlation with other measured substances,indicating independent sources.Health risk assessment results indicated that F−poses potential health risks to rural residents,while cadmium,due to its relatively low concentrations,does not currently present a significant health risk.Among different demographic groups,the health risk levels of F−exposure followed the order:Infants>children>adult females>adult males.The findings highlight that fluoride is the primary contributor to health risks associated with groundwater consumption in the study area.Strengthened monitoring and prevention of F−contamination are urgently needed.This research provides a scientific basis for the prevention and control of fluoride pollution in groundwater and offers practical guidance for safeguarding drinking water safety in rural China.展开更多
BACKGROUND Ischemic stroke is one of the leading global causes of disability and death.Despite advances in modern medical technology that improve acute treatment and rehabilitation measures,post-stroke anxiety and dep...BACKGROUND Ischemic stroke is one of the leading global causes of disability and death.Despite advances in modern medical technology that improve acute treatment and rehabilitation measures,post-stroke anxiety and depression(PSD)do not receive sufficient attention.AIM To systematically evaluate risk factors and early identification markers for PSD for more precise screening and intervention strategies in clinical practice.METHODS This retrospective study analyzed clinical data from 112 patients with ischemic stroke admitted between January 2022 and December 2024.Based on assessments using the Hamilton Rating Scale for Anxiety(HAMA)and Hamilton Rating Scale for Depression(HAMD)at 2 weeks(±3 days)post-stroke,patients were classified into the PSD group(HAMA≥7 and/or HAMD≥7)and the non-PSD group(HAMA<7 and HAMD<7).Observation indicators included psychological assessment,demographic and clinical characteristics,stroke-related clinical indicators,neuroimaging assessments,and laboratory biomarkers.Multivariate logistic regression analysis was used to identify independent risk factors for PSD,and receiver operating characteristic curve analysis was used to evaluate the diagnostic value of potential biomarkers.RESULTS Of the 112 patients,46(41.1%)were diagnosed with PSD.Multivariate analysis identified five independent risk factors:Female gender[Odds ratio(OR)=2.32,95%confidence interval(CI):1.56-3.45],history of mental disorders prior to stroke(OR=3.17,95%CI:1.89-5.32),infarct location in the frontal lobe or limbic system(OR=2.86,95%CI:1.73-4.71),stroke severity with National Institutes of Health Stroke Scale≥8 at admission(OR=2.54,95%CI:1.62-3.99),and low social support(Social Support Rating Scale<35,OR=2.18,95%CI:1.42-3.36).Subgroup analysis showed that depression patients more commonly had left hemisphere lesions(68.4%vs 45.2%),while anxiety patients more frequently presented with right hemisphere lesions(59.5%vs 39.5%).The PSD group exhibited larger infarct volumes(8.7 cm^(3) vs 5.3 cm^(3)),more severe white matter hyperintensities,and more pronounced frontal lobe atrophy.Analysis of inflammatory markers showed significantly elevated levels of interleukin-6(7.8 pg/mL vs 4.5 pg/mL)and tumor necrosis factor-alpha(15.6 pg/mL vs 9.8 pg/mL)in the PSD group,while hypothalamicpituitary-adrenal axis function assessment revealed higher cortisol levels(386.5±92.3 nmol/L vs 328.7±75.6 nmol/L)and flattened diurnal rhythm in the PSD group.CONCLUSION PSD is a complex neuropsychiatric consequence of stroke involving disruption of the frontal-limbic circuitry,neuroinflammatory responses,and dysfunction of the hypothalamic-pituitary-adrenal axis.展开更多
Virtual power plant(VPP)integrates a variety of distributed renewable energy and energy storage to participate in electricity market transactions,promote the consumption of renewable energy,and improve economic effici...Virtual power plant(VPP)integrates a variety of distributed renewable energy and energy storage to participate in electricity market transactions,promote the consumption of renewable energy,and improve economic efficiency.In this paper,aiming at the uncertainty of distributed wind power and photovoltaic output,considering the coupling relationship between power,carbon trading,and green cardmarket,the optimal operationmodel and bidding scheme of VPP in spot market,carbon trading market,and green card market are established.On this basis,through the Shapley value and independent risk contribution theory in cooperative game theory,the quantitative analysis of the total income and risk contribution of various distributed resources in the virtual power plant is realized.Moreover,the scheduling strategies of virtual power plants under different risk preferences are systematically compared,and the feasibility and accuracy of the combination of Shapley value and independent risk contribution theory in ensuring fair income distribution and reasonable risk assessment are emphasized.A comprehensive solution for virtual power plants in the multi-market environment is constructed,which integrates operation strategy,income distribution mechanism,and risk control system into a unified analysis framework.Through the simulation of multi-scenario examples,the CPLEXsolver inMATLAB software is used to optimize themodel.The proposed joint optimization scheme can increase the profit of VPP participating in carbon trading and green certificate market by 29%.The total revenue of distributed resources managed by VPP is 9%higher than that of individual participation.展开更多
Traditional psychiatric diagnosis relies on subjective symptom assessment,lacking objective biomarkers that hinder early detection and personalized treatment.Plasma proteins and polygenic risk score(PRS),as potential ...Traditional psychiatric diagnosis relies on subjective symptom assessment,lacking objective biomarkers that hinder early detection and personalized treatment.Plasma proteins and polygenic risk score(PRS),as potential predictive tools,hold promise for advancing early diagnosis of mental disorders.This study aims to evaluate the predictive potential of proteomic features and PRS in multiple mental illnesses(depression,schizophrenia,and post-traumatic stress disorder(PTSD)).Using participant data from the UK Biobank-Pharma Proteomics Project,we screen protein associations with mental disorders through least absolute shrinkage and selection operator(LASSO)analysis and construct a Cox regression risk prediction model by integrating the PRS.Additionally,we evaluate predictive performance using 6 machine learning methods and Kaplan-Meier survival curves.Our findings reveal distinct predictive patterns across dis-orders.For depression,integrating plasma proteins with PRS significantly improves prediction beyond the clinical model(C-index=0.6322).For schizophrenia,adding plasma proteins enhances predictive performance,whereas PRS provides no significant improvement.For PTSD,neither plasma proteins nor PRS add substantial predictive value beyond clinical variables.Risk stratification analysis demonstrat that all three mental disorders models can clearly distinguish high-risk from low-risk groups(depression:HR=2.34,P<0.001;schizophrenia:HR=5.47,P<0.001;PTSD:HR=3.02,P<0.001).Al-though it shows good performance in short-term prediction,its long-term prediction ability has decreased,and it needs to be further optimized in the future.This study underscores the differential utility of biomarkers across mental disorders and provides a rationale for disorder-specific predictive modeling in precision psychiatry.展开更多
Objectives:Uretero-enteric strictures are feared complications following cystectomy.Despite surgical advancements,particularly the rise of robot-assisted approaches,the risk factors associated with these strictures re...Objectives:Uretero-enteric strictures are feared complications following cystectomy.Despite surgical advancements,particularly the rise of robot-assisted approaches,the risk factors associated with these strictures remain poorly defined.This study aimed to identify the risk factors associated with uretero-enteric anastomotic strictures after cystectomy,according to the surgical approach and type of urinary diversion(extracorporeal vs.intracorporeal).Methods:We conducted a single-center retrospective study including 340 patients who underwent cystectomy between 2016 and 2024 at Tours University Hospital.Clinical,biological,perioperative,and postoperative data were analyzed.The occurrence of a uretero-ileal anastomotic stricture was defined radiologically by a uretero-hydronephrosis≥20 mm.We constructed and analyzed a learning curve for robotic surgery with intracorporeal urinary diversion.Results:Strictures occurred in 60 patients(17.6%).On multivariable analysis,reduced preoperative glomerular filtration rate(odds ratio[OR]=1.45 per 10 mL/min decrease,95%CI[1.12-1.87],p=0.004),elevated creatinine(OR=1.30 per 10μmol/L increase,95%CI[1.05-1.61],p=0.018),prior myocardial infarction(OR=2.25,95%CI[1.10-4.62],p=0.027),and postoperative urinary tract infection(OR=3.10,95%CI[1.65-5.82],p<0.001)were independent predictors.Most strictures were left-sided.Intracorporeal robotic diversion had a higher,though non-significant,stricture rate(21.5%vs.15.2%,OR=1.52,p=0.12).Stricture rates fell markedly after 20 robotic cases per surgeon(23.8%vs.12.1%).Conclusion:Uretero-enteric strictures are multifactorial,strongly influenced by baseline renal function,cardiovascular comorbidity,and postoperative infection.Robotic intracorporeal diversion shows a learning curve effect,underlining the importance of surgical expertise and infection prevention in reducing risk.展开更多
To address the critical challenge of risk perception and assessment for autonomous vehicles in dynamic interactive envi-ronments,this study proposes a semi-supervised spatiotemporal interaction risk cognition network ...To address the critical challenge of risk perception and assessment for autonomous vehicles in dynamic interactive envi-ronments,this study proposes a semi-supervised spatiotemporal interaction risk cognition network with attention mecha-nism(SS-SIRCN),inspired by the behavioral adaptation patterns of biological groups under external threats.First,by thoroughly analyzing the dynamic interaction characteristics exhibited by typical biological collectives when exposed to risk,the study reveals the underlying patterns of trajectory changes influenced by external danger.Then,an attention-based spatiotemporal risk cognition network is designed to establish a mapping between driving behavior features and potential driving risks.Finally,a semi-supervised learning framework is employed to enable risk assessment for autono-mous vehicles using only a small amount of labeled data.Experimental results on real-world vehicle trajectory datasets demonstrate that the proposed method achieves a risk prediction accuracy of 90.76%,outperforming other baseline models in performance.展开更多
Despite the widespread presence and frequent detection of polycyclic aromatic hydrocarbons(PAHs)in various aspects of life,there is limited research on their exposure levels in pregnant women and cumulative exposure f...Despite the widespread presence and frequent detection of polycyclic aromatic hydrocarbons(PAHs)in various aspects of life,there is limited research on their exposure levels in pregnant women and cumulative exposure from the living environment.This study included 1311 women in late pregnancy from the Zunyi birth cohort and measured the urinary concentrations of 10 hydroxylated PAH metabolites(OH-PAHs).Risk assessment was conducted based on the estimated daily intake to calculate the hazard quotient and hazard index(HI).A linear regression model was used to analyze the relationship between creatinine-adjusted OH-PAHs concentrations and living environment and lifestyle factors,while principal component analysis was applied to trace the sources of PAHs exposure.1-OHPYR was detected in all participants’urine,with naphthalene metabolites having the highest concentrations among creatinine-adjusted PAHs.OH-PAHs concentrations were associated with housing type,room number,cooking frequency,household size,exercise frequency,fuel type,distance from main road,and drinking water source.Pregnant women using traditional fuels and living in bungalows had higher health risks than those using clean energy and living in buildings.Those living within 100 m of a main road had higher HI than those farther away.Coal combustion was identified as the primary source of PAHs exposure.The study emphasizes the importance of reducing PAHs exposure,especially for pregnant women living in polluted environments.It recommends public health interventions such as improving indoor ventilation and providing clean energy to reduce related health risks.展开更多
基金supported by the 2025 Fujian Provincial Social Science Foundation Project(FJ2025C074).
文摘This systematic review synthesizes empirical research on external risk factors for adolescent smartphone addiction.Scopus and Web of Science were searched for English peer-reviewed empirical articles from 2008 onward;28 met inclusion criteria(excluding non-adolescents,generic internet addiction,non-empirical work,or non-English).Thematic synthesis organized findings into three external risk domains—family,school,and peers—considering cultural/contextual mechanisms.Family dynamics(parental phubbing,harsh parenting,dysfunction),school stressors,and adverse peer relationships were identified as accumulating,direct and indirect contributors to smartphone addiction.These operate within a techno-ecological framework,where digital technologies amplify vulnerabilities and create new pathways for maladaptive use.Evidence favors an ecological,multi-level perspective.Future research should use longitudinal designs,standardize measures across cultures,and examine understudied regions—especially Africa—to guide culturally sensitive interventions.
基金funded by China Law Society 2025 Annual Legal Research,Project grant number:CLS(2025)Y04.
文摘Background:Medical artificial intelligence(MAI)is a synthesis of medical science and artificial intelligence development,serving as a crucial field in the current advancement and application of AI.In the process of developing medical AI,there may arise not only legal risks such as infringement of privacy rights and health rights but also ethical risks stemming from violations of the principles of beneficence and non-maleficence.Methods:To effectively address the damages caused by MAI in the future,it is necessary to establish a hierarchical governance system with MAI.This paper examines the systematic collection of local practices in China and the induction and integration of legal remedies for the damage of MAI.Results:To effectively address the ethical and legal challenges of medical artificial intelligence,a hierarchical regulatory system should be established,which based on the impact of intervention measures on natural rights and differences in intervention timing.This paper finally obtains a legal hierarchical governance system corresponding to the ethical risks and legal risks of MAI in China.Conclusion:The Chinese government has formed a multi-agent governance system based on the impact of risks on rights and the timing of legal intervention,which provides a reference for other countries to follow up on the research on MAI risk management.
基金supported by Hebei Natural Science Foundation(No.JZX2023018)Hebei Natural Science Foundation(No.C2022201042)the 100 Foreign Experts Plans of Hebei Province(No.606080123001).
文摘Antibiotics are widespread in aquatic environments due to their extensive use in human healthcare and ani-mal husbandry.However,research on the occurrence and bioaccumulation of antibiotics in aquatic organisms within shallow wetland lakes remains limited.This study investigated the occurrence and bioaccumulation of ten commonly used antibiotics in the Baiyang Lake,northern China’s largest shallow wetland lake.The results indicated that sulfonamides and fluoroquinolones were the predominant antibiotics in surface water,whereas fluoroquinolones and macrolides were more prevalent in sediment.Fluoroquinolones demonstrated significant potential for bioaccumulation in targeted aquatic organisms,including both animals and plants(Carassius au-ratus and Phragmites australis).The bioaccumulation of antibiotics in Carassius auratus was correlated with their solubility,whereas in Phragmites australis,this was associated with their octanol-water partition coefficients and molecular weights.Ecological risk assessment indicated that most antibiotics posed minimal to low risk levels.However,four antibiotics were exceptions:clarithromycin(12.5%)and sulfamethoxazole(6.25%)presented a high risk in surface water samples,while norfloxacin(25.0%)and ciprofloxacin(25.0%)posed a high risk in sediment samples.Norfloxacin,ciprofloxacin,and roxithromycin were identified as key indicator antibiotics for enhancing the local monitoring and control of antibiotic contamination based on four criteria:(1)high con-centrations,(2)frequent detection,(3)capacity for bioaccumulation,and(4)ecological risk levels.This study contributes to a deeper understanding of the status of antibiotic contamination,bioaccumulation characteristics,and ecological risk in Baiyang Lake,thereby supporting efforts to monitor and regulate antibiotic pollution.
文摘Flood risk in South Africa remains a problem due to climate change,rapid urbanisation and persistent disparities in the region and low-income urban households are disproportionately impacted because of poor access to affordable flood insurance.This paper constructs the Integrated Market Flood Risk Insurance Framework(IMFRIF)based on a qualitative,desk-based research design consisting of contextual policy analysis,systematic literature review and analytical synthesis through systems thinking.The policy and document analysis reviewed the legislation on national disaster management,insurance and industry reports to determine institutional and market limitations on the provision of flood insurance.A PRISMA-ScR systematic literature review filtered 312 records on Scopus,Web of Science,and Google Scholar,which led to the identification of 47 peer-reviewed articles and 15 policy and comparative case studies.Thematic analysis led to the identification of six prevail-ing clusters of barriers based on the influence on insurance uptake,which included affordability and product design,trust and risk perception,data and risk assessment gaps,regulatory capacity,multi-stakeholder coordi-nation,and community engagement.The results of these studies were used to design the IMFRIF,a system incorporating 9 major stakeholder groups and 5 interdependent system components into a single market-based design.The framework provides a systematic foundation to the resolution of systemic exclusion of flood insur-ance,but specifically acknowledges the implementation limitations regarding data availability,regulation ca-pacity,fiscal sustainability and communal level of trust.The IMFRIF is placed as a progressive and responsive system that offers a point of future empirical confirmation and policy implementation to promote inclusive disaster risk financing in South Africa and comparable low-and middle-income contexts.
基金funded by Medical and Health Science and Technology Project of Zhejiang province(Grant number:2023KY633).
文摘Objective:To evaluate the cost-effectiveness of annual trivalent inactivated influenza vaccine(IIV3)under the context of Zhejiang province.Methods:A state transition simulation model was constructed to estimate the health and economic outcomes of IIV3 vaccination program compared to no vaccination for hypothetical cohorts of Zhejiang province stratified by age and risk status.Model input parameters were chosen based on published literatures and expert advices.The analysis used societal perspectives and a one-year time horizon,and permanent outcomes were also included.The primary outcome was the incremental cost-effectiveness ratio(ICER),with expression of US dollars per quality adjusted life years(QALYs)gained.Results:In subgroups not at high risk for influenza-related complications(non-high risk subgroup),ICER ranged from $6268/QALY(for adults aged 50-64 years)to $11260/QALY(for children aged from 6 months to 4 years).In subgroups at high risk for influenza-related complications(high risk subgroup),ICER ranged from cost-saving(adults aged≥65 years)to $5260/QALY(for children aged from 6 months to 4 years).ICER were most sensitive to changes in probability of influenza illness,cost of hospitalization,and probability of death for adults aged 18-49 years with non-high risk status.Conclusions:ICERs of annual influenza vaccination varied by age and risk status but were less than the Gross Domestic Product(GDP)per capita of Zhejiang province($17745 in 2023),which remained cost-effective for all-age and different risk status groups from a societal perspective.
基金supported by the Fund for Health Promotion from Osaka Prefecture。
文摘Objective:We assessed the risk for physical inactivity due to inadequate health literacy using multivariable analysis in a large middleaged population.Methods:This cross-sectional mail survey using a self-administered questionnaire was conducted in 2020 and included 33,902 community residents aged 40-64 years from 5 cities in Osaka Prefecture,Japan.Of these,12,446(36.7%)agreed to participate in the survey.After exclusion of those with regular visits to medical institutions and those with missing data,the analysis included 3742 participants.Health literacy was measured by the communicative and critical health literacy(CCHL)scale,and participants were classified into 3 groups(low,medium,and high health literacy groups)by the tertiles of the CCHL scale score.Physical inactivity was defined as not completing at least 150 min of moderate-intensity physical activity throughout the week.Results:After adjustment for age,gender,education level,occupation,economic status,living alone,and stages of health behavior change,the multivariable-adjusted odds ratios(ORs)for physical inactivity were 1.36(95% confidence interval[CI]:1.16-1.59,P<0.001)in the medium health literacy group and 1.70(95%CI:1.36-2.11,P<0.001)in the low health literacy group compared with the high health literacy group.Conclusions:This large-scale study provides compelling evidence that those with inadequate health literacy are at higher risk for physical inactivity among middle-aged adults.
文摘Purpose-This study explores how managerial leadership and organizational innovation interact to enhance resilience and risk management in railway supply chains and how these capabilities contribute to sustained competitive advantage.It emphasizes the strategic importance of resilience in railway systems that face operational complexity,regulatory pressures and increasing exposure to systemic risks.Design/methodology/approach-A mixed-methods design was employed,integrating survey data from 186 railway organizations with six case studies involving railway operators,rolling stock manufacturers and supply chain partners across multiple regions.Constructs were measured using validated scales and hypothesized relationships were tested using Structural Equation Modeling(SEM).Case study interviews were analyzed thematically to provide contextual understanding of leadership practices and innovation strategies.Findings-The results confirm that transformational managerial leadership significantly predicts innovation adoption,which in turn strengthens resilience and risk management capabilities.Resilience emerged as a powerful driver of competitive advantage,reinforcing its role as a strategic capability rather than a reactive response to disruptions.Furthermore,innovation was shown to partially mediate the relationship between leadership and resilience,highlighting its function as the operational channel through which vision translates into capability.Originality/value-This study contributes to the literature by integrating the Resource-Based View(RBV)and Dynamic Capabilities(DC)framework into the context of railway supply chains.It is among the first to empirically validate the mediating role of innovation between leadership and resilience,offering both theoretical advancements and actionable strategies for building resilient and competitive railway systems.
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 ScientificResearch Fund of National Health Commission of the People’s Republic of China-Major Science and Technology Program for Medicine and Health in Zhejiang Province(WKJ-ZJ-2406).
文摘Objectives This study aimed to explore the lagged and cumulative effects of risk factors on disability in older adults using distributed lag non-linear models(DLNMs).Methods We utilized data from the China Health and Retirement Longitudinal Study(CHARLS).After feature selection via Elastic Net Regularization,we applied DLNMs to evaluate the lagged effects of risk factors.Disability was defined as the presence of any difficulties in basic activities of daily living(BADL).The cumulative relative risk(CRR)was calculated by summing the lag-specific risk estimates,representing the cumulative disability risk over the specified lag period.Effect modifications and sensitivity analyses were also performed.Results This study included a total of 2,318 participants.Early-phase lag factors,such as the difficulty in stooping(CRR=3.58;95%CI:2.31-5.55;P<0.001)and walking(CRR=2.77;95%CI:1.39-5.55;P<0.001),exerted the strongest effects immediately upon occurrence.Mid-phase lag factors,such as arthritis(CRR=1.51;95%CI:1.10-2.06;P=0.001),showed a resurgence in disability risk within 2-3 years.Late-phase lag factors,including depressive symptoms(CRR=2.38;95%CI:1.30-4.35;P<0.001)and elevated systolic blood pressure(CRR=1.64;95%CI:1.06-2.79;P=0.02),exhibited significant long-term cumulative risks.Conversely,grip strength(CRR=0.80;95%CI:0.54-0.95;P=0.02)and social participation(CRR=0.89;95%CI:0.73-0.99;P=0.04)were significant protective factors.Conclusions The findings underscore the importance of tailored interventions that account for various lag characteristics of different factors to effectively mitigate disability risk.Future studies should explore the underlying biological and sociological mechanisms of these lagged effects,identify intervention strategies that target risk factors with different lagged patterns,and evaluate their effectiveness.
文摘As one of the main chronic diseases in modern society,coronary heart disease,as a major disease that affects people’s lives and health,has the characteristics of hidden onset and sudden onset.Coronary heart disease has relatively clear risk factors.Among them,blood lipid levels and blood sugar levels,as two main risk factors,play an important role in promoting the onset of coronary heart disease.The two complement each other in a vicious cycle,synergize and promote each other,promote the process of coronary atherosclerosis,thereby causing coronary heart disease.Multiple components in blood lipids and poor management of long-term blood sugar levels play a major role in specific clinical problems.This article reviews the different components of blood lipids and the effects of hyperglycemia on coronary heart disease,and initially expounds the mechanism by which blood lipids and blood sugar levels synergize each other to aggravate the risk of coronary heart disease,and combines them with relevant clinical issues,in order to help clinicians guide the prevention of coronary heart disease in terms of blood lipids and blood sugar levels.
基金supported by the National Natural Science Foundation of China(42361144880)the Science and Technology Program of Xizang Autonomous Region,China(XZ202402ZD0001)the Qinghai Province Basic Research Program Project,China(2024-ZJ-904).
文摘Debris flow events are frequent in Tajikistan,yet comprehensive investigations at the regional scale are limited.This study integrates remote sensing,Geographic Information System,and machine learning techniques to evaluate debris flow susceptibility and associated hazards across Tajikistan.A dataset comprising 405 documented debris flow points and 14 influencing factors,encompassing geological,climatic-hydrological,and anthropogenic variables,was established.Three machine learning algorithms—Random Forest,Support Vector Machine(SVM),and Multi-layer Perceptron—were applied to generate susceptibility maps and delineate debris flow risk zones.The results indicate that the areas of higher and high susceptibility accounted for 20.43%and 4.41%of the national area,respectively,and were predominantly concentrated along the Zeravshan and Vakhsh river basins.Among the evaluated models,SVM model demonstrated the highest predictive performance.Beyond conventional topographic and environmental controls,drought conditions were identified as a critical factor influencing debris flow occurrence within the arid and semi-arid mountainous regions of Tajikistan.These findings provide a scientific basis for regional debris flow risk management and disaster mitigation planning,and offer practical guidance for selecting conditioning factors in machine-learning-based susceptibility assessments in other dry mountainous environments.
基金supported by the Henan Provincial Medical Science and Technology Research Program,grant funded by the Henan Provincial Health Commission(No.LHGJ 20200888)。
文摘Objective:To investigate the related factors of motility after total hip arthroplasty(THA).Methods:The convenience sampling method was used to include 213 patients receiving THA in our hospital from June 2020 to June 2023.They were divided into 2 groups according to the occurrence of kinesiophobia after THA.The demographic data of the 2 groups were analyzed by single-factor analysis.The factors with statistically significant differences were analyzed by binary logistic regression as independent variables.Finally,Spearman analysis was used to analyze the relationship between risk factors and the degree of kinesiophobia.Results:Among 213 THA patients,38 patients were diagnosed with kinetophobia,and the incidence of kinetophobia was 17.84%.visual analogue scale(VAS)and pain duration before operation were higher in patients with kinetophobia than in patients without kinetophobia.The scores of education level,self-efficacy,and social support were significantly lower than those of the non-phobia group,with statistical significance(P<0.05).Logistic regression analysis showed that VAS was a risk factor for kinetophobia after THA.Education level and self-efficacy were protective factors to reduce the occurrence of kinetophobia after THA(P<0.05).Spearman correlation analysis showed that the degree of pain(r=0.697,P<0.001)was positively correlated with the degree of kinetophobia,while the degree of education(r=-0.647,P<0.001)and self-efficacy(r=-0.756,P<0.001)were negatively correlated with the degree of kinetophobia.Conclusions:The degree of pain is a risk factor of kinesiophobia after THA,and it is positively correlated with the degree.Educational level and self-efficacy were protective factors to reduce the incidence of kinesiophobia and were negatively correlated with the degree of kinesiophobia.
基金supported by the Northeast Geological Science and Technology Innovation Center of China Geological Survey(Grant NO.QCJJ2022-43)the Natural Resources Comprehensive Survey Project(Grant Nos.DD20230470,DD20230508)the National Groundwater Monitoring Network Operation and Maintenance Program(Grant No.DD20251300109).
文摘Excessive levels of Fluoride(F−)and Cadmium(Cd)in drinking groundwater may pose health risks.This study assessed the health risks associated with F−and Cd contamination in rural drinking groundwater sources in Wutai County,Shanxi Province,China,to support population health protection,water resource management,and environmental decision-making.Groundwater samples were collected and analyzed,and a Human Health Risk Model(HHRA)was applied to evaluate groundwater quality.The results showed that both contents of F−and Cd in groundwater exceeded the Class III limits of China's national groundwater quality standard(GB/T 14848—2024).Fluoride levels met the Class V threshold,with enrichment area mainly located in the east part of the study area.Cadmium levels reached Class IV,with elevated concentrations primarily observed in the western and northwestern regions.Correlation analysis revealed that F−showed weak or no correlation with other measured substances,indicating independent sources.Health risk assessment results indicated that F−poses potential health risks to rural residents,while cadmium,due to its relatively low concentrations,does not currently present a significant health risk.Among different demographic groups,the health risk levels of F−exposure followed the order:Infants>children>adult females>adult males.The findings highlight that fluoride is the primary contributor to health risks associated with groundwater consumption in the study area.Strengthened monitoring and prevention of F−contamination are urgently needed.This research provides a scientific basis for the prevention and control of fluoride pollution in groundwater and offers practical guidance for safeguarding drinking water safety in rural China.
文摘BACKGROUND Ischemic stroke is one of the leading global causes of disability and death.Despite advances in modern medical technology that improve acute treatment and rehabilitation measures,post-stroke anxiety and depression(PSD)do not receive sufficient attention.AIM To systematically evaluate risk factors and early identification markers for PSD for more precise screening and intervention strategies in clinical practice.METHODS This retrospective study analyzed clinical data from 112 patients with ischemic stroke admitted between January 2022 and December 2024.Based on assessments using the Hamilton Rating Scale for Anxiety(HAMA)and Hamilton Rating Scale for Depression(HAMD)at 2 weeks(±3 days)post-stroke,patients were classified into the PSD group(HAMA≥7 and/or HAMD≥7)and the non-PSD group(HAMA<7 and HAMD<7).Observation indicators included psychological assessment,demographic and clinical characteristics,stroke-related clinical indicators,neuroimaging assessments,and laboratory biomarkers.Multivariate logistic regression analysis was used to identify independent risk factors for PSD,and receiver operating characteristic curve analysis was used to evaluate the diagnostic value of potential biomarkers.RESULTS Of the 112 patients,46(41.1%)were diagnosed with PSD.Multivariate analysis identified five independent risk factors:Female gender[Odds ratio(OR)=2.32,95%confidence interval(CI):1.56-3.45],history of mental disorders prior to stroke(OR=3.17,95%CI:1.89-5.32),infarct location in the frontal lobe or limbic system(OR=2.86,95%CI:1.73-4.71),stroke severity with National Institutes of Health Stroke Scale≥8 at admission(OR=2.54,95%CI:1.62-3.99),and low social support(Social Support Rating Scale<35,OR=2.18,95%CI:1.42-3.36).Subgroup analysis showed that depression patients more commonly had left hemisphere lesions(68.4%vs 45.2%),while anxiety patients more frequently presented with right hemisphere lesions(59.5%vs 39.5%).The PSD group exhibited larger infarct volumes(8.7 cm^(3) vs 5.3 cm^(3)),more severe white matter hyperintensities,and more pronounced frontal lobe atrophy.Analysis of inflammatory markers showed significantly elevated levels of interleukin-6(7.8 pg/mL vs 4.5 pg/mL)and tumor necrosis factor-alpha(15.6 pg/mL vs 9.8 pg/mL)in the PSD group,while hypothalamicpituitary-adrenal axis function assessment revealed higher cortisol levels(386.5±92.3 nmol/L vs 328.7±75.6 nmol/L)and flattened diurnal rhythm in the PSD group.CONCLUSION PSD is a complex neuropsychiatric consequence of stroke involving disruption of the frontal-limbic circuitry,neuroinflammatory responses,and dysfunction of the hypothalamic-pituitary-adrenal axis.
基金funded by the Department of Education of Liaoning Province and was supported by the Basic Scientific Research Project of the Department of Education of Liaoning Province(Grant No.LJ222411632051)and(Grant No.LJKQZ2021085)Natural Science Foundation Project of Liaoning Province(Grant No.2022-BS-222).
文摘Virtual power plant(VPP)integrates a variety of distributed renewable energy and energy storage to participate in electricity market transactions,promote the consumption of renewable energy,and improve economic efficiency.In this paper,aiming at the uncertainty of distributed wind power and photovoltaic output,considering the coupling relationship between power,carbon trading,and green cardmarket,the optimal operationmodel and bidding scheme of VPP in spot market,carbon trading market,and green card market are established.On this basis,through the Shapley value and independent risk contribution theory in cooperative game theory,the quantitative analysis of the total income and risk contribution of various distributed resources in the virtual power plant is realized.Moreover,the scheduling strategies of virtual power plants under different risk preferences are systematically compared,and the feasibility and accuracy of the combination of Shapley value and independent risk contribution theory in ensuring fair income distribution and reasonable risk assessment are emphasized.A comprehensive solution for virtual power plants in the multi-market environment is constructed,which integrates operation strategy,income distribution mechanism,and risk control system into a unified analysis framework.Through the simulation of multi-scenario examples,the CPLEXsolver inMATLAB software is used to optimize themodel.The proposed joint optimization scheme can increase the profit of VPP participating in carbon trading and green certificate market by 29%.The total revenue of distributed resources managed by VPP is 9%higher than that of individual participation.
基金The National Natural Science Foundation of China-Regional Science“Identification of novel drug targets for lung cancer via Mendelian randomization analysis based on blood proteomics”(62362062)The 2025 Xinjiang University Excellent Graduate Innovation Project“Research on identification of therapeutic targets and predictive factors for mental disorders based on proteomics”(XJDX2025YJS151)。
文摘Traditional psychiatric diagnosis relies on subjective symptom assessment,lacking objective biomarkers that hinder early detection and personalized treatment.Plasma proteins and polygenic risk score(PRS),as potential predictive tools,hold promise for advancing early diagnosis of mental disorders.This study aims to evaluate the predictive potential of proteomic features and PRS in multiple mental illnesses(depression,schizophrenia,and post-traumatic stress disorder(PTSD)).Using participant data from the UK Biobank-Pharma Proteomics Project,we screen protein associations with mental disorders through least absolute shrinkage and selection operator(LASSO)analysis and construct a Cox regression risk prediction model by integrating the PRS.Additionally,we evaluate predictive performance using 6 machine learning methods and Kaplan-Meier survival curves.Our findings reveal distinct predictive patterns across dis-orders.For depression,integrating plasma proteins with PRS significantly improves prediction beyond the clinical model(C-index=0.6322).For schizophrenia,adding plasma proteins enhances predictive performance,whereas PRS provides no significant improvement.For PTSD,neither plasma proteins nor PRS add substantial predictive value beyond clinical variables.Risk stratification analysis demonstrat that all three mental disorders models can clearly distinguish high-risk from low-risk groups(depression:HR=2.34,P<0.001;schizophrenia:HR=5.47,P<0.001;PTSD:HR=3.02,P<0.001).Al-though it shows good performance in short-term prediction,its long-term prediction ability has decreased,and it needs to be further optimized in the future.This study underscores the differential utility of biomarkers across mental disorders and provides a rationale for disorder-specific predictive modeling in precision psychiatry.
文摘Objectives:Uretero-enteric strictures are feared complications following cystectomy.Despite surgical advancements,particularly the rise of robot-assisted approaches,the risk factors associated with these strictures remain poorly defined.This study aimed to identify the risk factors associated with uretero-enteric anastomotic strictures after cystectomy,according to the surgical approach and type of urinary diversion(extracorporeal vs.intracorporeal).Methods:We conducted a single-center retrospective study including 340 patients who underwent cystectomy between 2016 and 2024 at Tours University Hospital.Clinical,biological,perioperative,and postoperative data were analyzed.The occurrence of a uretero-ileal anastomotic stricture was defined radiologically by a uretero-hydronephrosis≥20 mm.We constructed and analyzed a learning curve for robotic surgery with intracorporeal urinary diversion.Results:Strictures occurred in 60 patients(17.6%).On multivariable analysis,reduced preoperative glomerular filtration rate(odds ratio[OR]=1.45 per 10 mL/min decrease,95%CI[1.12-1.87],p=0.004),elevated creatinine(OR=1.30 per 10μmol/L increase,95%CI[1.05-1.61],p=0.018),prior myocardial infarction(OR=2.25,95%CI[1.10-4.62],p=0.027),and postoperative urinary tract infection(OR=3.10,95%CI[1.65-5.82],p<0.001)were independent predictors.Most strictures were left-sided.Intracorporeal robotic diversion had a higher,though non-significant,stricture rate(21.5%vs.15.2%,OR=1.52,p=0.12).Stricture rates fell markedly after 20 robotic cases per surgeon(23.8%vs.12.1%).Conclusion:Uretero-enteric strictures are multifactorial,strongly influenced by baseline renal function,cardiovascular comorbidity,and postoperative infection.Robotic intracorporeal diversion shows a learning curve effect,underlining the importance of surgical expertise and infection prevention in reducing risk.
基金the Jilin Provincial Department of Science and Technology Youth Science and Technology Talent Cultivation Project(20250602051RC)Fundamental Research Funds for the Central Universities(2025-JCXK-19)National Natural Science Foundation of China under Grant 52272417.
文摘To address the critical challenge of risk perception and assessment for autonomous vehicles in dynamic interactive envi-ronments,this study proposes a semi-supervised spatiotemporal interaction risk cognition network with attention mecha-nism(SS-SIRCN),inspired by the behavioral adaptation patterns of biological groups under external threats.First,by thoroughly analyzing the dynamic interaction characteristics exhibited by typical biological collectives when exposed to risk,the study reveals the underlying patterns of trajectory changes influenced by external danger.Then,an attention-based spatiotemporal risk cognition network is designed to establish a mapping between driving behavior features and potential driving risks.Finally,a semi-supervised learning framework is employed to enable risk assessment for autono-mous vehicles using only a small amount of labeled data.Experimental results on real-world vehicle trajectory datasets demonstrate that the proposed method achieves a risk prediction accuracy of 90.76%,outperforming other baseline models in performance.
基金supported by the National Key R&D Program of China(Nos.2018YFC1004300 and 2018YFC1004302)the Science&Technology Program of Guizhou Province(Nos.QKHHBZ[2020]3002,QKHPTRC-GCC[2022]039-1 and QKHPTRCCXTD[2022]014)the Scientific Research Program of Guizhou Provincial Department of Education(No.QJJ[2023]019).
文摘Despite the widespread presence and frequent detection of polycyclic aromatic hydrocarbons(PAHs)in various aspects of life,there is limited research on their exposure levels in pregnant women and cumulative exposure from the living environment.This study included 1311 women in late pregnancy from the Zunyi birth cohort and measured the urinary concentrations of 10 hydroxylated PAH metabolites(OH-PAHs).Risk assessment was conducted based on the estimated daily intake to calculate the hazard quotient and hazard index(HI).A linear regression model was used to analyze the relationship between creatinine-adjusted OH-PAHs concentrations and living environment and lifestyle factors,while principal component analysis was applied to trace the sources of PAHs exposure.1-OHPYR was detected in all participants’urine,with naphthalene metabolites having the highest concentrations among creatinine-adjusted PAHs.OH-PAHs concentrations were associated with housing type,room number,cooking frequency,household size,exercise frequency,fuel type,distance from main road,and drinking water source.Pregnant women using traditional fuels and living in bungalows had higher health risks than those using clean energy and living in buildings.Those living within 100 m of a main road had higher HI than those farther away.Coal combustion was identified as the primary source of PAHs exposure.The study emphasizes the importance of reducing PAHs exposure,especially for pregnant women living in polluted environments.It recommends public health interventions such as improving indoor ventilation and providing clean energy to reduce related health risks.
