Gastrointestinal tumors require personalized treatment strategies due to their heterogeneity and complexity.Multimodal artificial intelligence(AI)addresses this challenge by integrating diverse data sources-including ...Gastrointestinal tumors require personalized treatment strategies due to their heterogeneity and complexity.Multimodal artificial intelligence(AI)addresses this challenge by integrating diverse data sources-including computed tomography(CT),magnetic resonance imaging(MRI),endoscopic imaging,and genomic profiles-to enable intelligent decision-making for individualized therapy.This approach leverages AI algorithms to fuse imaging,endoscopic,and omics data,facilitating comprehensive characterization of tumor biology,prediction of treatment response,and optimization of therapeutic strategies.By combining CT and MRI for structural assessment,endoscopic data for real-time visual inspection,and genomic information for molecular profiling,multimodal AI enhances the accuracy of patient stratification and treatment personalization.The clinical implementation of this technology demonstrates potential for improving patient outcomes,advancing precision oncology,and supporting individualized care in gastrointestinal cancers.Ultimately,multimodal AI serves as a transformative tool in oncology,bridging data integration with clinical application to effectively tailor therapies.展开更多
BACKGROUND Hepatocellular carcinoma ranks among the most prevalent malignant neoplasms.Surgical intervention constitutes a critical therapeutic approach for this condition.Nonetheless,postoperative recovery is frequen...BACKGROUND Hepatocellular carcinoma ranks among the most prevalent malignant neoplasms.Surgical intervention constitutes a critical therapeutic approach for this condition.Nonetheless,postoperative recovery is frequently influenced by the patient's nutritional status and the quality of nursing care provided.AIM To examine the comprehensive impact of personalized nutritional support and nursing strategies on the postoperative rehabilitation of patients with liver cancer.METHODS In this study,a retrospective comparative analysis was conducted involving 60 post-operative liver cancer patients.The subjects were selected as subjects and divided into two groups based on differing nursing interventions,with each group comprising 30 patients.The control group received standard nutritional support and care,whereas the experimental group received individualized nutritional support and nursing strategies.The study aimed to evaluate the impact of individualized nutrition by comparing the rehabilitation indices,nutritional status,quality of life(QoL),and complication rates between the two groups.RESULTS The results showed that the recovery index of the experimental group was significantly better than that of the control group 2 weeks after surgery,and the average liver function recovery index of the experimental group was 85.significantly higher than that of the control group(73.67±7.19).In terms of nutritional status,the serum albumin level and body weight stabilization rate of the experimental group were also significantly higher than those of the control group,which were 42.33±2.4 g/L and 93.3%,respectively,compared with 36.01±3.85 g/L and 76.7%of the control group.In addition,the average QoL score of the experimental group was 84.66±3.7 points,which was significantly higher than that of the control group(70.92±4.28 points).At the psychological level,the average anxiety score of the experimental group was 1.17±0.29,and the average depression score was 1.47±0.4,which were significantly lower than the 2.26±0.42 and 2.57±0.45 of the control group.This showed that patients in the experimental group were better relieved of anxiety and depression under the individualized nutrition support and nursing strategy.More importantly,the complication rate in the experimental group was only 10%,much lower than the 33.3%in the control group.CONCLUSION Personalized nutritional support and tailored nursing strategies significantly enhance the postoperative rehabilitation of liver cancer patients.Consequently,it is recommended to implement and advocate for these individualized approaches to improve both the recovery outcomes and QoL for these patients.展开更多
Objectives To identify core symptoms and symptom clusters in patients with neuromyelitis optica spectrum disorder(NMOSD)by network analysis.Methods From October 10 to 30,2023,140 patients with NMOSD were selected to p...Objectives To identify core symptoms and symptom clusters in patients with neuromyelitis optica spectrum disorder(NMOSD)by network analysis.Methods From October 10 to 30,2023,140 patients with NMOSD were selected to participate in this online questionnaire survey.The survey tools included a general information questionnaire and a self-made NMOSD symptoms scale,which included the prevalence,severity,and distress of 29 symptoms.Cluster analysis was used to identify symptom clusters,and network analysis was used to analyze the symptom network and node characteristics and central indicators including strength centrality(r_(s)),closeness centrality(r_(c))and betweeness centrality(r_(b))were used to identify core symptoms and symptom clusters.Results The most common symptom was pain(65.7%),followed by paraesthesia(65.0%),fatigue(65.0%),easy awakening(63.6%).Regarding the burden level of symptoms,pain was the most burdensome symptom,followed by paraesthesia,easy awakening,fatigue,and difficulty falling asleep.Six clusters were identified:somatosensory,motor,visual,and memory symptom clusters,bladder and rectum symptom clusters,sleep symptoms clusters,and neuropsychological symptom clusters.Fatigue(r_(s)=12.39,r_(b)=68.00,r_(c)=0.02)was the most central and prominent bridge symptom,and motor symptom cluster(r_(s)=2.68,r_(c)=0.10)was the most central symptom cluster among the six clusters.Conclusions Our study demonstrated the necessity of symptom management targeting fatigue,pain,and motor symptom cluster in patients with NMOSD.展开更多
An aluminoborate,Na_(2.5)Rb[Al{B_(5)O_(10)}{B_(3)O_(5)}]·0.5NO_(3)·H_(2)O(1),was synthesized under hydrothermal condition,which was built by mixed oxoboron clusters and AlO_(4)tetrahedra.In the structure,the...An aluminoborate,Na_(2.5)Rb[Al{B_(5)O_(10)}{B_(3)O_(5)}]·0.5NO_(3)·H_(2)O(1),was synthesized under hydrothermal condition,which was built by mixed oxoboron clusters and AlO_(4)tetrahedra.In the structure,the[B_(5)O_(10)]^(5-)and[B_(3)O_(7)]^(5-)clusters are alternately connected to form 1D[B_(8)O_(15)]_(n)^(6n-)chains,which are further linked by AlO_(4)units to form a 2D monolayer with 7‑membered ring and 10‑membered ring windows.Two adjacent monolayers with opposite orientations further form a porous‑layered structure with six channels through B—O—Al bonds.Compound 1 was characterized by single crystal X‑ray diffraction,powder X‑ray diffraction(PXRD),IR spectroscopy,UV‑Vis diffuse reflection spectroscopy,and thermogravimetric analysis(TGA),respectively.UV‑Vis diffuse reflectance analysis indicates that compound 1 shows a wide transparency range with a short cutoff edge of 201 nm,suggesting it may have potential application in UV regions.CCDC:2383923.展开更多
Ultrafine,highly dispersed Pt clusters were immobilized onto the Co nanoparticle surfaces by one-step pyrolysis of the precursor Pt(Ⅱ)-encapsulating Co-MOF-74.Owing to the small size effects of Pt clusters as well as...Ultrafine,highly dispersed Pt clusters were immobilized onto the Co nanoparticle surfaces by one-step pyrolysis of the precursor Pt(Ⅱ)-encapsulating Co-MOF-74.Owing to the small size effects of Pt clusters as well as the strongly enhanced synergistic interactions between Pt and Co atoms,the obtained Pt-on-Co/C400 catalysts exhib-ited excellent catalytic activity toward the hydrolysis of ammonia borane with an extremely high turnover frequency(TOF)value of 3022 min^(-1)at 303 K.Durability test indicated that the obtained Pt-on-Co/C400 catalysts possessed high catalytic stability,and there were no changes in the catalyst structures and catalytic activities after 10 cycles.展开更多
In modern distributed systems and cloud computing architectures,high availability and high scalability are core requirements to ensure the continuous and stable operation of services.As key technologies for achieving ...In modern distributed systems and cloud computing architectures,high availability and high scalability are core requirements to ensure the continuous and stable operation of services.As key technologies for achieving these two goals,high-availability clusters and load-balancing clusters have significant differences in their design concepts and application scenarios,while also maintaining close connections.This paper aims to conduct an in-depth analysis of the core objectives,working principles,technical advantages and disadvantages,and typical application cases of high-availability clusters and load-balancing clusters.By introducing an analogical model of a“restaurant kitchen,”the differences between the two are intuitively explained,and their technical characteristics are compared in detail.Additionally,a detailed practical case is included to specifically demonstrate the collaborative work of high-availability and load-balancing technologies through the construction process of Keepalived and HAProxy.Finally,taking the architecture of a typical e-commerce website as an example,this paper demonstrates the best practice of organically combining the two cluster technologies in a production environment to build a robust and high-performance distributed system.Research shows that understanding the differences between the two and implementing collaborative deployment is the cornerstone of designing modern IT infrastructure.展开更多
Attributed graph clustering plays a vital role in uncovering hidden network structures,but it presents significant challenges.In recent years,various models have been proposed to identify meaningful clusters by integr...Attributed graph clustering plays a vital role in uncovering hidden network structures,but it presents significant challenges.In recent years,various models have been proposed to identify meaningful clusters by integrating both structural and attribute-based information.However,these models often emphasize node proximities without adequately balancing the efficiency of clustering based on both structural and attribute data.Furthermore,they tend to neglect the critical fuzzy information inherent in attributed graph clusters.To address these issues,we introduce a new framework,Markov lumpability optimization,for efficient clustering of large-scale attributed graphs.Specifically,we define a lumped Markov chain on an attribute-augmented graph and introduce a new metric,Markov lumpability,to quantify the differences between the original and lumped Markov transition probability matrices.To minimize this measure,we propose a conjugate gradient projectionbased approach that ensures the partitioning closely aligns with the intrinsic structure of fuzzy clusters through conditional optimization.Extensive experiments on both synthetic and real-world datasets demonstrate the superior performance of the proposed framework compared to existing clustering algorithms.This framework has many potential applications,including dynamic community analysis of social networks,user profiling in recommendation systems,functional module identification in biological molecular networks,and financial risk control,offering a new paradigm for mining complex patterns in high-dimensional attributed graph data.展开更多
Chiral metal-organic clusters(MOCs)integrating lanthanide ions(Ln^(3+))and organic luminophores present a promising platform for modulating circularly polarized luminescence(CPL).However,achieving dual-wavelength CPL ...Chiral metal-organic clusters(MOCs)integrating lanthanide ions(Ln^(3+))and organic luminophores present a promising platform for modulating circularly polarized luminescence(CPL).However,achieving dual-wavelength CPL in discrete cluster systems constitutes a considerable challenge.Herein,two enantiomeric pairs of heterometallic EuSn oxo clusters,designated as Sn_(2)EuL_(2)-R/S and Sn_(2)EuL_(4)-R/S,were strategically synthesized using axially chiral binaphthol-phosphonate ligands.These hybrid clusters exhibit dual emission,characterized by a broad ligand-derived fluorescence band superimposed with sharp,characteristic Eu^(3+)f-f transitions,which enables excitation-dependent luminescence color tuning.Their emission profiles and quantum yields are found to be exquisitely adjusted by the distinct coordination environments of Sn^(4+)centers.Notably,Sn_(2)EuL_(2)-R/S demonstrates CPL activity in both near-UV(|g_(lum)|=1.7×10^(-3))and visible(|g_(lum)|=3.1×10^(-2))regions.This work not only reports the first instance of dual-wavelength CPL in a lanthanide/tin oxo complex but also establishes a robust design strategy for fabricating color-tunable chiral photonic materials.展开更多
Animals can differ in their individual movement behaviors during their daily displacements.Studies of animal movement patterns often disregard the need to understand individual variation in these patterns and the role...Animals can differ in their individual movement behaviors during their daily displacements.Studies of animal movement patterns often disregard the need to understand individual variation in these patterns and the role of this variation in shaping population distributions of movements.To assess the link between individual movements and population distributions,we radio-tracked 13 Fowler's Toads Anaxyrus fowleri in Long Point,Ontario,Canada,after their breeding season.We recorded individual coordinates every 30 min,from the moment they emerged from their burrows around dusk until they burrowed in the morning,and obtained a total of 157 movements.We used the resulting series of step lengths and turning angles in a Hidden Markov Model to estimate movement type as"directed"or"non-directed"We also assigned to each encounter one of 3 space-dependent movement states:"foraging""in transit'or"searching"and found that movement type and state switched within individuals irrespective of time during a single night.We find that switching between movement types varied throughout the night,leading to stochastic within-individual variation in movements,and the distribution of movement distances differed significantly among individuals.Movement states,however,were time-dependent,suggesting displacement routines were similar across individuals.Variation in movement behavior within individuals scales up to result in variation among individuals which,in turn,was found to shape the distribution of the sampled population.Our findings therefore underline the importance of a multi-scale approach in the study of movement.展开更多
Accurate description of noncova-lent interactions in large systems is challenging due to the require-ment of high-level electron corre-lation methods.The generalized energy-based fragmentation(GEBF)approach,in conjunc...Accurate description of noncova-lent interactions in large systems is challenging due to the require-ment of high-level electron corre-lation methods.The generalized energy-based fragmentation(GEBF)approach,in conjunc-tion with the domain-based local pair natural orbital(DLPNO)method,has been applied to assess the average binding energies(ABEs)of large benzene clus-ters,specifically(C6H6)13,at the coupled cluster singles and doubles with perturbative triples correction[CCSD(T)]level and the complete basis set(CBS)limit.Utilizing GEBF-DLPNO-CCSD(T)/CBS ABEs as benchmarks,various DFT functionals were evaluated.It was found that several functionals with empirical dispersion correction,including M06-2X-D3,B3LYP-D3(BJ),and PBE-D3(BJ),provide accurate descriptions of the ABEs for(C6H6)13 clusters.Additionally,the M06-2X-D3 functional was used to calculate the ABEs and relative stabili-ties of(C6H6)n clusters for n=11,12,13,14,and 15 revealing that the(C6H6)13 cluster ex-hibits the highest relative stability.These findings align with experimental evidence suggest-ing that n=13 is one of the magic numbers for benzene clusters(C6H6)n,with n≤30.展开更多
Vocal individuality is essential for social discrimination but has been poorly studied in animals that produce communal signals(duets or choruses).Song overlapping and temporal coordination make the assessment of indi...Vocal individuality is essential for social discrimination but has been poorly studied in animals that produce communal signals(duets or choruses).Song overlapping and temporal coordination make the assessment of individuality in communal signals more complex.In addition,selection may favor the accurate identifcation of pairs over individuals by receivers in year-round territorial species with duetting and long-term pair bonding.Here,we studied pair and individual vocal signatures in the polyphonal duets of rufous horneros Furnarius rufus,a Neotropical bird known for its long-term pair bonds.Hornero partners engage in duets to deter territorial intruders and protect their partnership year-round and can discern duets from neighbors versus strangers.Using a dataset of 471 duets from 43 pairs in 2 populations,we measured fne-scale acoustic features across different duet levels(e.g.,complete duets to non-overlapping syllable parts)and analysis levels(pair or individual).Permuted linear discriminant function analyses classifed pairs and individuals more accurately than expected by chance(means:45%and 47%vs.4 and 2%).Pair identity explained more variance in the multivariate acoustic features of duets than individual or population identities.The initial frequency of the duet showed strong potential for encoding pair identity.The acoustic traits contributing most to individual vocal signatures varied between sexes,which might facilitate the simultaneous assessment of duetters’identities by receivers.Our study indicates that vocal individuality may exist even in species with intricate and innate communal signals and elucidates the mechanisms employed by horneros in their social discrimination ability.展开更多
BACKGROUND Magnetic resonance imaging(MRI)and endoscopic ultrasonography(EUS)are recommended in combination for screening pancreatic cancer in high-risk individuals.However,in clinical practice,MRI and EUS are increas...BACKGROUND Magnetic resonance imaging(MRI)and endoscopic ultrasonography(EUS)are recommended in combination for screening pancreatic cancer in high-risk individuals.However,in clinical practice,MRI and EUS are increasingly utilized for pancreatic surveillance during routine health examinations.AIM To investigate the feasibility of these imaging modalities for screening in low-risk individuals.METHODS This retrospective study included patients at low risk for pancreatic cancer who underwent MRI or EUS at two health evaluation centers between March 2019 and December 2024.Basic characteristics,laboratory data,and imaging results were collected.RESULTS A total of 3364 low-risk individuals underwent pancreatic screening:1553(46.1%)received MRI,and 1811 underwent EUS.No significant differences were observed in age or sex distribution between the groups.In imaging screening,EUS demonstrated a higher detection rate of abnormal pancreatic lesions(12.8%vs 2.6%;P<0.001).MRI detected more cystic lesions than did EUS(P<0.001).EUS identified smaller nodular lesions compared to MRI(9.2 mm vs 18.0 mm;P=0.044).The MRI group had a higher number of confirmed intraductal papillary mucinous neoplasms(P=0.031),whereas the EUS group identified more suspected branch-duct intraductal papillary mucinous neoplasms(P<0.001).Pancreatic adenocarcinoma was found in three patients(0.08%),with no significant difference in detection rates between EUS and MRI(0.11%vs 0.06%;P=0.656).CONCLUSION In low-risk individuals,MRI and EUS offer comparable effectiveness for pancreatic cancer surveillance.The choice of imaging strategy for health evaluation depends on cost considerations and degree of invasiveness.展开更多
Light hydrocarbons(LHs)are key components of petroleum,and the carbon isotopes composition(δ^(13)C)of individual LHs contains a wealth of geochemical information.Forty-four oil samples from five different basins were...Light hydrocarbons(LHs)are key components of petroleum,and the carbon isotopes composition(δ^(13)C)of individual LHs contains a wealth of geochemical information.Forty-four oil samples from five different basins were analyzed using gas chromatography(GC),gas chromatography-mass spectrometry(GC–MS),and gas chromatography-isotope ratio mass spectrometry(GC-IRMS).Theδ^(13)C values of forty-three LHs were recognized and determined by comparing the GC and GC-IRMS methods.The results revealed significant differences inδ^(13)C distribution characteristics among different LH compounds.Theδ^(13)C variation of individual LHs in iso-paraffins showed the widest range,followed by cycloalkanes and aromatics,whereas theδ^(13)C variation in n-paraffins showed the narrowest range.Theδ^(13)C values of most individual LHs are primarily affected by the source facies and thermal evolution.Among them,c-1,3-dimethylcyclohexane(c-1,3DMCH)is mainly sourced from higher plants but may also form through abiotic mechanisms such as catalysis or cyclization.Theδ^(13)C values of c-1,3DMCH(δ^(13)Cc-1,3DMCH)primarily exhibit parental genetic characteristics,enabling effective distinction of oil from different source facies.Specifically,theδ^(13)Cc-1,3DMCH in marine oils,lacustrine oils,terrigenous oils,and coal-formed oils are<–22‰,from–22‰to−20.2‰,from−20.2‰to−18.4‰,and>−18.4‰,respectively.Moreover,maturity is the primary controlling factor forδ^(13)C values of 3MC7(δ^(13)C3MC7,3MC7:3-methylheptane),while the source facies serve as a secondary influence.The plot ofδ^(13)Cc-1,3DMCH andδ^(13)C3MC7 was introduced to classify source facies.Asδ^(13)Cc-1,3DMCH andδ^(13)C3MC7 increase,the source facies transits from marine to lacustrine,then terrigenous,and finally coal facies.Additionally,increasingδ^(13)C3MC7 indicates a relative increase in maturity.Therefore,theδ^(13)Cc-1,3DMCH vs.δ^(13)C3MC7 plot serves as an effective tool for distinguishing source facies and assessing relative maturity.展开更多
Background There is insufficient evidence to provide recommendations for leisure-time physical activity among workers across various occupational physical activity levels.This study aimed to assess the association of ...Background There is insufficient evidence to provide recommendations for leisure-time physical activity among workers across various occupational physical activity levels.This study aimed to assess the association of leisure-time physical activity with cardiovascular and all-cause mortality across occupational physical activity levels.Methods This study utilized individual participant data from 21 cohort studies,comprising both published and unpublished data.Eligibility criteria included individual-level data on leisure-time and occupational physical activity(categorized as sedentary,low,moderate,and high)along with data on all-cause and/or cardiovascular mortality.A 2-stage individual participant data meta-analysis was conducted,with separate analysis of each study using Cox proportional hazards models(Stage 1).These results were combined using random-effects models(Stage 2).Results Higher leisure-time physical activity levels were associated with lower all-cause and cardiovascular mortality risk across most occupational physical activity levels,for both males and females.Among males with sedentary work,high compared to sedentary leisure-time physical activity was associated with lower all-cause(hazard ratios(HR)=0.77,95%confidence interval(95%CI):0.70-0.85)and cardiovascular mortality(HR=0.76,95%CI:0.66-0.87)risk.Among males with high levels of occupational physical activity,high compared to sedentary leisure-time physical activity was associated with lower all-cause(HR=0.84,95%CI:0.74-0.97)and cardiovascular mortality(HR=0.79,95%CI:0.60-1.04)risk,while HRs for low and moderate levels of leisure-time physical activity ranged between 0.87 and 0.97 and were not statistically significant.Among females,most effects were similar but more imprecise,especially in the higher occupational physical activity levels.Conclusion Higher levels of leisure-time physical activity were generally associated with lower mortality risks.However,results for workers with moderate and high occupational physical activity levels,especially women,were more imprecise.Our findings suggests that workers may benefit from engaging in high levels of leisure-time physical activity,irrespective of their level of occupational physical activity.展开更多
The theory of human dignity identifies certain inherent human characteristics,elevating humanity as the pinnacle of creation and valuing individuals as carriers of these traits.Under this framework,individuals are cal...The theory of human dignity identifies certain inherent human characteristics,elevating humanity as the pinnacle of creation and valuing individuals as carriers of these traits.Under this framework,individuals are called to actively embody their human essence and participate in political life to serve the community.Overall,this interpretive paradigm of dignity establishes a distinct concept of autonomy and provides methods for its realization,fostering the secularization of politics by emphasizing human value.The doctrine of individual dignity presupposes the intrinsic worth of individuals and defends their autonomy and equal status through the imposition of legal obligations on the state.However,limited by its essentialist and communitarian orientation,the scope of autonomy and equality it provides to individuals remains constrained.By transcending ontology with a value-based approach,the concept of individual dignity creates a unique,open structure that incorporates and reflects on global human rights practices.This adaptability enables it to integrate abstract societies,advance the global human rights agenda,and critique and refine political realities.Consequently,the concept of individual dignity cannot be supplanted by the human dignity theory.展开更多
Objective This study aimed to investigate the prevalence of HIV pretreatment drug resistance(PDR)and the transmission clusters associated with PDR-related mutations in newly diagnosed,treatmentnaive patients between 2...Objective This study aimed to investigate the prevalence of HIV pretreatment drug resistance(PDR)and the transmission clusters associated with PDR-related mutations in newly diagnosed,treatmentnaive patients between 2020 and 2023 in Dehong prefecture,Yunnan province,China.Methods Demographic information and plasma samples were collected from study participants.PDR was assessed using the Stanford HIV Drug Resistance Database.The Tamura-Nei 93 model within HIVTRACE was employed to compute pairwise matches with a genetic distance of 0.015 substitutions per site.Results Among 948 treatment-naive individuals with eligible sequences,36 HIV subtypes were identified,with unique recombinant forms(URFs)being the most prevalent(18.8%,178/948).The overall prevalence of PDR was 12.4%(118/948),and resistance to non-nucleotide reverse transcriptase inhibitors(NNRTIs),nucleotide reverse transcriptase inhibitors(NRTIs),and protease inhibitors(PIs)was10.7%,1.3%,and 1.6%,respectively.A total of 91 clusters were identified,among which eight showed evidence of PDR strain transmission.The largest PDR-associated cluster consisted of six CRF01_AE drugresistant strains carrying K103N and V179T mutations;five of these individuals had initial CD4^(+)cell counts<200 cells/μL.Conclusion The distribution of HIV subtypes in Dehong is diverse and complex.PDR was moderately prevalent(12.4%)between 2020 and 2023.Evidence of transmission of CRF01_AE strains carrying K103N and V179T mutations was found.Routine surveillance of PDR and the strengthening of control measures are essential to limit the spread of drug-resistance HIV strains.展开更多
Objective:To identify key factors influencing cognitive function in the elderly,including traditional Chinese medicine(TCM)constitutional classification,and to rank their relative importance.Methods:We used cross-sect...Objective:To identify key factors influencing cognitive function in the elderly,including traditional Chinese medicine(TCM)constitutional classification,and to rank their relative importance.Methods:We used cross-sectional data from seven geographical regions across Chinese mainland.The Changsha version of the Montreal Cognitive Assessment was used to assess cognitive function.A“least absolute shrinkage and selection operator”(LASSO)model,multivariate linear regression analysis,and random forest(RF)model were used.Subgroup analyses were performed to examine the correlation between key TCM constitution types and cognitive function in different population subgroups.Results:A total of 24803 individuals aged 60 and above were included in the study.We selected 18 influential factors using the LASSO model.Higher education,being married,and having insurance were positively correlated with cognitive function in the elderly(all P<0.05).In contrast,poor sleep,vision impairment,hearing impairment,basic activities of daily living disability,instrumental activities of daily living disability,depression,hypertension,coronary heart disease,diabetes,stroke,yang-deficiency constitution(YADC),yin-deficiency constitution(YIDC),qi deficiency constitution(QDC),and blood stasis constitution(BSC)were negatively correlated with cognitive function(all P<0.05).YIDC and BSC affected all dimensions of cognitive function(all P<0.05).YADC mainly affected attention,language,abstraction(verbal analogies),memory,and orientation to time and place dimensions(P<0.001).QDC mainly affected language and abstraction(verbal analogies)dimensions(P<0.05).The negative correlations between BSC,YADC,YIDC,and QDC scores and cognitive function revealed statistically significant dif-ferences across most subgroups.The RF model identified education,BSC,and poor sleep quality as the three most influential factors in our study.Conclusion:BSC,YADC,YIDC,and QDC were associated with cognitive decline in the elderly.Our findings provide new perspectives and significant references for interventions for early-stage cognitive disorders.展开更多
The first three months after lung transplantation are the clinical“vulnerable period”.Complications during this period often appear in the form of symptom clusters.The core includes primary graft dysfunction(PGD),in...The first three months after lung transplantation are the clinical“vulnerable period”.Complications during this period often appear in the form of symptom clusters.The core includes primary graft dysfunction(PGD),infection,inflammatory response and multiple organ dysfunction,and are interconnected to form a complex network.The symptom cluster shows a clear dynamic trajectory:the risk of PGD peaks at 24 hours after surgery,and its evolution trajectory(recovery,delay,deterioration)directly affects long-term graft function;infections show a“double peak distribution”,with bacteria/fungi dominant in the early stage(<1 month)and viruses/opportunistic infections dominant in the middle stage(1-6 months),and promote each other with PGD.Influencing factors include four dimensions:donor(smoking history,infection),recipient(weakness,immune status),perioperative period(surgical method,support strategy)and postoperative management(balance of immunosuppression).In the future,dynamic prediction models and individualized management paths need to be built to improve patient outcomes.展开更多
LiNO_(3) is known to significantly enhance the reversibility of lithium metal batteries;however,the modification of solvation structures in various solvents and its further impact on the interface have not been fully ...LiNO_(3) is known to significantly enhance the reversibility of lithium metal batteries;however,the modification of solvation structures in various solvents and its further impact on the interface have not been fully revealed.Herein,we systematically studied the evolution of solvation structures with increasing LiNO_(3) concentration in both carbonate and ether electrolytes.The results from molecular dynamics simulations unveil that the Li^(+)solvation structure is less affected in carbonate electrolytes,while in ether electrolytes,there is a significant decrease of solvent molecules in Li^(+)coordination,and a larger average size of Li^(+)solvation structure emerges as LiNO_(3) concentration increases.Notably,the formation of large ion aggregates with size of several nanometers(nano-clusters),is observed in ether-based electrolytes at conventional Li^(+)concentration(1 M)with higher NO_(3)^(-) ratio,which is further proved by infrared spectroscopy and small-angle X-ray scattering experiments.The nano-clusters with abundant anions are endowed with a narrow energy gap of molecular orbitals,contributing to the formation of an inorganic rich electrode/electrolyte interphase that enhances the reversibility of lithium stripping/plating with Coulombic efficiency up to 99.71%.The discovery of nano-clusters elucidates the underlying mechanism linking ions/solvent aggregation states of electrolytes to interfacial stability in advanced battery systems.展开更多
Objectives:This study aimed to determine the effectiveness of an individual and family selfmanagement(IFSM)education program on triglyceride-glucose(TyG)index,self-management,and diabetes distress among adults with un...Objectives:This study aimed to determine the effectiveness of an individual and family selfmanagement(IFSM)education program on triglyceride-glucose(TyG)index,self-management,and diabetes distress among adults with uncontrolled diabetes mellitus type 2(T2DM).Methods:A multicentre randomized controlled trial was employed.The study included 68 dyads(adults with uncontrolled T2DM and one family member)that were randomly allocated to the intervention(n=34)and control groups(n=34)from March to September 2024.Participants in the intervention group received an 8-week IFSM education program,whereas those in the control group received standard routine care.An automated hematology analyzer XP-100 was used to evaluate triglyceride and fasting blood glucose levels.The Diabetes Distress Scale and Diabetes Self-Management Questionnaire were used to measure diabetes distress and self-management,respectively.Results:A total of 67 participants completed the intervention.The generalized estimating equation demonstrated a significantinteraction between group and time.The IFSM education intervention group had a higher diabetes self-management(β=16.68;95%CI=15.23,18.09;P<0.001),lower diabetes distress(β=-30.74;95%CI=-32.57,-28.90;P<0.001),and lower TyG index(β=-1.97;95%CI=-2.41,-1.53;P<0.001)than the control group.Conclusions:The findingsdocumented the capacity of IFSM education to reduce TyG and diabetes distress,which could potentially escalate diabetes self-management among individuals with T2DM.展开更多
基金Supported by Xuhui District Health Commission,No.SHXH202214.
文摘Gastrointestinal tumors require personalized treatment strategies due to their heterogeneity and complexity.Multimodal artificial intelligence(AI)addresses this challenge by integrating diverse data sources-including computed tomography(CT),magnetic resonance imaging(MRI),endoscopic imaging,and genomic profiles-to enable intelligent decision-making for individualized therapy.This approach leverages AI algorithms to fuse imaging,endoscopic,and omics data,facilitating comprehensive characterization of tumor biology,prediction of treatment response,and optimization of therapeutic strategies.By combining CT and MRI for structural assessment,endoscopic data for real-time visual inspection,and genomic information for molecular profiling,multimodal AI enhances the accuracy of patient stratification and treatment personalization.The clinical implementation of this technology demonstrates potential for improving patient outcomes,advancing precision oncology,and supporting individualized care in gastrointestinal cancers.Ultimately,multimodal AI serves as a transformative tool in oncology,bridging data integration with clinical application to effectively tailor therapies.
文摘BACKGROUND Hepatocellular carcinoma ranks among the most prevalent malignant neoplasms.Surgical intervention constitutes a critical therapeutic approach for this condition.Nonetheless,postoperative recovery is frequently influenced by the patient's nutritional status and the quality of nursing care provided.AIM To examine the comprehensive impact of personalized nutritional support and nursing strategies on the postoperative rehabilitation of patients with liver cancer.METHODS In this study,a retrospective comparative analysis was conducted involving 60 post-operative liver cancer patients.The subjects were selected as subjects and divided into two groups based on differing nursing interventions,with each group comprising 30 patients.The control group received standard nutritional support and care,whereas the experimental group received individualized nutritional support and nursing strategies.The study aimed to evaluate the impact of individualized nutrition by comparing the rehabilitation indices,nutritional status,quality of life(QoL),and complication rates between the two groups.RESULTS The results showed that the recovery index of the experimental group was significantly better than that of the control group 2 weeks after surgery,and the average liver function recovery index of the experimental group was 85.significantly higher than that of the control group(73.67±7.19).In terms of nutritional status,the serum albumin level and body weight stabilization rate of the experimental group were also significantly higher than those of the control group,which were 42.33±2.4 g/L and 93.3%,respectively,compared with 36.01±3.85 g/L and 76.7%of the control group.In addition,the average QoL score of the experimental group was 84.66±3.7 points,which was significantly higher than that of the control group(70.92±4.28 points).At the psychological level,the average anxiety score of the experimental group was 1.17±0.29,and the average depression score was 1.47±0.4,which were significantly lower than the 2.26±0.42 and 2.57±0.45 of the control group.This showed that patients in the experimental group were better relieved of anxiety and depression under the individualized nutrition support and nursing strategy.More importantly,the complication rate in the experimental group was only 10%,much lower than the 33.3%in the control group.CONCLUSION Personalized nutritional support and tailored nursing strategies significantly enhance the postoperative rehabilitation of liver cancer patients.Consequently,it is recommended to implement and advocate for these individualized approaches to improve both the recovery outcomes and QoL for these patients.
基金supported by the Specific Research Fund for Top-notch Talents of Guangdong Provincial Hospital of Chinese Medicine(No.2022KT1188).
文摘Objectives To identify core symptoms and symptom clusters in patients with neuromyelitis optica spectrum disorder(NMOSD)by network analysis.Methods From October 10 to 30,2023,140 patients with NMOSD were selected to participate in this online questionnaire survey.The survey tools included a general information questionnaire and a self-made NMOSD symptoms scale,which included the prevalence,severity,and distress of 29 symptoms.Cluster analysis was used to identify symptom clusters,and network analysis was used to analyze the symptom network and node characteristics and central indicators including strength centrality(r_(s)),closeness centrality(r_(c))and betweeness centrality(r_(b))were used to identify core symptoms and symptom clusters.Results The most common symptom was pain(65.7%),followed by paraesthesia(65.0%),fatigue(65.0%),easy awakening(63.6%).Regarding the burden level of symptoms,pain was the most burdensome symptom,followed by paraesthesia,easy awakening,fatigue,and difficulty falling asleep.Six clusters were identified:somatosensory,motor,visual,and memory symptom clusters,bladder and rectum symptom clusters,sleep symptoms clusters,and neuropsychological symptom clusters.Fatigue(r_(s)=12.39,r_(b)=68.00,r_(c)=0.02)was the most central and prominent bridge symptom,and motor symptom cluster(r_(s)=2.68,r_(c)=0.10)was the most central symptom cluster among the six clusters.Conclusions Our study demonstrated the necessity of symptom management targeting fatigue,pain,and motor symptom cluster in patients with NMOSD.
文摘An aluminoborate,Na_(2.5)Rb[Al{B_(5)O_(10)}{B_(3)O_(5)}]·0.5NO_(3)·H_(2)O(1),was synthesized under hydrothermal condition,which was built by mixed oxoboron clusters and AlO_(4)tetrahedra.In the structure,the[B_(5)O_(10)]^(5-)and[B_(3)O_(7)]^(5-)clusters are alternately connected to form 1D[B_(8)O_(15)]_(n)^(6n-)chains,which are further linked by AlO_(4)units to form a 2D monolayer with 7‑membered ring and 10‑membered ring windows.Two adjacent monolayers with opposite orientations further form a porous‑layered structure with six channels through B—O—Al bonds.Compound 1 was characterized by single crystal X‑ray diffraction,powder X‑ray diffraction(PXRD),IR spectroscopy,UV‑Vis diffuse reflection spectroscopy,and thermogravimetric analysis(TGA),respectively.UV‑Vis diffuse reflectance analysis indicates that compound 1 shows a wide transparency range with a short cutoff edge of 201 nm,suggesting it may have potential application in UV regions.CCDC:2383923.
文摘Ultrafine,highly dispersed Pt clusters were immobilized onto the Co nanoparticle surfaces by one-step pyrolysis of the precursor Pt(Ⅱ)-encapsulating Co-MOF-74.Owing to the small size effects of Pt clusters as well as the strongly enhanced synergistic interactions between Pt and Co atoms,the obtained Pt-on-Co/C400 catalysts exhib-ited excellent catalytic activity toward the hydrolysis of ammonia borane with an extremely high turnover frequency(TOF)value of 3022 min^(-1)at 303 K.Durability test indicated that the obtained Pt-on-Co/C400 catalysts possessed high catalytic stability,and there were no changes in the catalyst structures and catalytic activities after 10 cycles.
文摘In modern distributed systems and cloud computing architectures,high availability and high scalability are core requirements to ensure the continuous and stable operation of services.As key technologies for achieving these two goals,high-availability clusters and load-balancing clusters have significant differences in their design concepts and application scenarios,while also maintaining close connections.This paper aims to conduct an in-depth analysis of the core objectives,working principles,technical advantages and disadvantages,and typical application cases of high-availability clusters and load-balancing clusters.By introducing an analogical model of a“restaurant kitchen,”the differences between the two are intuitively explained,and their technical characteristics are compared in detail.Additionally,a detailed practical case is included to specifically demonstrate the collaborative work of high-availability and load-balancing technologies through the construction process of Keepalived and HAProxy.Finally,taking the architecture of a typical e-commerce website as an example,this paper demonstrates the best practice of organically combining the two cluster technologies in a production environment to build a robust and high-performance distributed system.Research shows that understanding the differences between the two and implementing collaborative deployment is the cornerstone of designing modern IT infrastructure.
基金supported by the National Natural Science Foundation of China(Grant No.72571150)Beijing Natural Science Foundation(Grant No.9182015)。
文摘Attributed graph clustering plays a vital role in uncovering hidden network structures,but it presents significant challenges.In recent years,various models have been proposed to identify meaningful clusters by integrating both structural and attribute-based information.However,these models often emphasize node proximities without adequately balancing the efficiency of clustering based on both structural and attribute data.Furthermore,they tend to neglect the critical fuzzy information inherent in attributed graph clusters.To address these issues,we introduce a new framework,Markov lumpability optimization,for efficient clustering of large-scale attributed graphs.Specifically,we define a lumped Markov chain on an attribute-augmented graph and introduce a new metric,Markov lumpability,to quantify the differences between the original and lumped Markov transition probability matrices.To minimize this measure,we propose a conjugate gradient projectionbased approach that ensures the partitioning closely aligns with the intrinsic structure of fuzzy clusters through conditional optimization.Extensive experiments on both synthetic and real-world datasets demonstrate the superior performance of the proposed framework compared to existing clustering algorithms.This framework has many potential applications,including dynamic community analysis of social networks,user profiling in recommendation systems,functional module identification in biological molecular networks,and financial risk control,offering a new paradigm for mining complex patterns in high-dimensional attributed graph data.
基金financially supported by the National Natural Science Foundation of China(22471268)the National Key Research and Development Project(2022YFA1503900)+2 种基金the Strategic Priority Research Program of the Chinese Academy of Sciences(XDB1170000)the Natural Science Foundation of Fujian Province(2022J05090,2024T3003)the Self-deployment Project Research Program of Haixi Institutes,Chinese Academy of Sciences(CXZX-2022-GH03,CXZX-2024-JQ08).
文摘Chiral metal-organic clusters(MOCs)integrating lanthanide ions(Ln^(3+))and organic luminophores present a promising platform for modulating circularly polarized luminescence(CPL).However,achieving dual-wavelength CPL in discrete cluster systems constitutes a considerable challenge.Herein,two enantiomeric pairs of heterometallic EuSn oxo clusters,designated as Sn_(2)EuL_(2)-R/S and Sn_(2)EuL_(4)-R/S,were strategically synthesized using axially chiral binaphthol-phosphonate ligands.These hybrid clusters exhibit dual emission,characterized by a broad ligand-derived fluorescence band superimposed with sharp,characteristic Eu^(3+)f-f transitions,which enables excitation-dependent luminescence color tuning.Their emission profiles and quantum yields are found to be exquisitely adjusted by the distinct coordination environments of Sn^(4+)centers.Notably,Sn_(2)EuL_(2)-R/S demonstrates CPL activity in both near-UV(|g_(lum)|=1.7×10^(-3))and visible(|g_(lum)|=3.1×10^(-2))regions.This work not only reports the first instance of dual-wavelength CPL in a lanthanide/tin oxo complex but also establishes a robust design strategy for fabricating color-tunable chiral photonic materials.
基金funded by grants from the Fonds de Recherche du Quebec-Nature et Technologies(FRQNT)to NJthe Ontario Ministry of Natural Resources and Forestrythe Ontario Ministry of Environment,Conservation and Parks,and the Natural Sciences and Engineering Research Council(NSERC)of Canada to DMG.
文摘Animals can differ in their individual movement behaviors during their daily displacements.Studies of animal movement patterns often disregard the need to understand individual variation in these patterns and the role of this variation in shaping population distributions of movements.To assess the link between individual movements and population distributions,we radio-tracked 13 Fowler's Toads Anaxyrus fowleri in Long Point,Ontario,Canada,after their breeding season.We recorded individual coordinates every 30 min,from the moment they emerged from their burrows around dusk until they burrowed in the morning,and obtained a total of 157 movements.We used the resulting series of step lengths and turning angles in a Hidden Markov Model to estimate movement type as"directed"or"non-directed"We also assigned to each encounter one of 3 space-dependent movement states:"foraging""in transit'or"searching"and found that movement type and state switched within individuals irrespective of time during a single night.We find that switching between movement types varied throughout the night,leading to stochastic within-individual variation in movements,and the distribution of movement distances differed significantly among individuals.Movement states,however,were time-dependent,suggesting displacement routines were similar across individuals.Variation in movement behavior within individuals scales up to result in variation among individuals which,in turn,was found to shape the distribution of the sampled population.Our findings therefore underline the importance of a multi-scale approach in the study of movement.
基金supported by the National Key R&D Program of China(No.2023YFB3712504)the National Natural Science Foundation of China(Nos.22273038,22073043,and 22033004)。
文摘Accurate description of noncova-lent interactions in large systems is challenging due to the require-ment of high-level electron corre-lation methods.The generalized energy-based fragmentation(GEBF)approach,in conjunc-tion with the domain-based local pair natural orbital(DLPNO)method,has been applied to assess the average binding energies(ABEs)of large benzene clus-ters,specifically(C6H6)13,at the coupled cluster singles and doubles with perturbative triples correction[CCSD(T)]level and the complete basis set(CBS)limit.Utilizing GEBF-DLPNO-CCSD(T)/CBS ABEs as benchmarks,various DFT functionals were evaluated.It was found that several functionals with empirical dispersion correction,including M06-2X-D3,B3LYP-D3(BJ),and PBE-D3(BJ),provide accurate descriptions of the ABEs for(C6H6)13 clusters.Additionally,the M06-2X-D3 functional was used to calculate the ABEs and relative stabili-ties of(C6H6)n clusters for n=11,12,13,14,and 15 revealing that the(C6H6)13 cluster ex-hibits the highest relative stability.These findings align with experimental evidence suggest-ing that n=13 is one of the magic numbers for benzene clusters(C6H6)n,with n≤30.
基金P.D.and P.S.A.received Ph.D.scholarships from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior(CAPES)(Finance Code 001)P.D.received a Postdoctoral fellowship from CAPES(grant number:88887.469218/2019-00)+4 种基金R.H.M.received a fellowship from Conselho Nacional de Desenvolvimento Científco e Tecnológico(CNPq)for the duration of the study.Funding was also provided by Animal Behavior Society[ABS Student Research Grant to P.S.A.]Association of Field Ornithologists[E.Alexander Bergstrom Memorial Research Award to P.S.A.]American Ornithological Society[Postdoctoral Research Award to P.D.]the logistic and fnancial support provided by Programa de Pós-Graduação em Ecologia from Universidade de Brasília in association with Programa de Excelência Acadêmica PROEX/CAPES(1789/2015)the fnancial support provided by CNPq(471945/2013-7).
文摘Vocal individuality is essential for social discrimination but has been poorly studied in animals that produce communal signals(duets or choruses).Song overlapping and temporal coordination make the assessment of individuality in communal signals more complex.In addition,selection may favor the accurate identifcation of pairs over individuals by receivers in year-round territorial species with duetting and long-term pair bonding.Here,we studied pair and individual vocal signatures in the polyphonal duets of rufous horneros Furnarius rufus,a Neotropical bird known for its long-term pair bonds.Hornero partners engage in duets to deter territorial intruders and protect their partnership year-round and can discern duets from neighbors versus strangers.Using a dataset of 471 duets from 43 pairs in 2 populations,we measured fne-scale acoustic features across different duet levels(e.g.,complete duets to non-overlapping syllable parts)and analysis levels(pair or individual).Permuted linear discriminant function analyses classifed pairs and individuals more accurately than expected by chance(means:45%and 47%vs.4 and 2%).Pair identity explained more variance in the multivariate acoustic features of duets than individual or population identities.The initial frequency of the duet showed strong potential for encoding pair identity.The acoustic traits contributing most to individual vocal signatures varied between sexes,which might facilitate the simultaneous assessment of duetters’identities by receivers.Our study indicates that vocal individuality may exist even in species with intricate and innate communal signals and elucidates the mechanisms employed by horneros in their social discrimination ability.
文摘BACKGROUND Magnetic resonance imaging(MRI)and endoscopic ultrasonography(EUS)are recommended in combination for screening pancreatic cancer in high-risk individuals.However,in clinical practice,MRI and EUS are increasingly utilized for pancreatic surveillance during routine health examinations.AIM To investigate the feasibility of these imaging modalities for screening in low-risk individuals.METHODS This retrospective study included patients at low risk for pancreatic cancer who underwent MRI or EUS at two health evaluation centers between March 2019 and December 2024.Basic characteristics,laboratory data,and imaging results were collected.RESULTS A total of 3364 low-risk individuals underwent pancreatic screening:1553(46.1%)received MRI,and 1811 underwent EUS.No significant differences were observed in age or sex distribution between the groups.In imaging screening,EUS demonstrated a higher detection rate of abnormal pancreatic lesions(12.8%vs 2.6%;P<0.001).MRI detected more cystic lesions than did EUS(P<0.001).EUS identified smaller nodular lesions compared to MRI(9.2 mm vs 18.0 mm;P=0.044).The MRI group had a higher number of confirmed intraductal papillary mucinous neoplasms(P=0.031),whereas the EUS group identified more suspected branch-duct intraductal papillary mucinous neoplasms(P<0.001).Pancreatic adenocarcinoma was found in three patients(0.08%),with no significant difference in detection rates between EUS and MRI(0.11%vs 0.06%;P=0.656).CONCLUSION In low-risk individuals,MRI and EUS offer comparable effectiveness for pancreatic cancer surveillance.The choice of imaging strategy for health evaluation depends on cost considerations and degree of invasiveness.
基金funded by the National Natural Science Foundation of China(Grant No.42173054).
文摘Light hydrocarbons(LHs)are key components of petroleum,and the carbon isotopes composition(δ^(13)C)of individual LHs contains a wealth of geochemical information.Forty-four oil samples from five different basins were analyzed using gas chromatography(GC),gas chromatography-mass spectrometry(GC–MS),and gas chromatography-isotope ratio mass spectrometry(GC-IRMS).Theδ^(13)C values of forty-three LHs were recognized and determined by comparing the GC and GC-IRMS methods.The results revealed significant differences inδ^(13)C distribution characteristics among different LH compounds.Theδ^(13)C variation of individual LHs in iso-paraffins showed the widest range,followed by cycloalkanes and aromatics,whereas theδ^(13)C variation in n-paraffins showed the narrowest range.Theδ^(13)C values of most individual LHs are primarily affected by the source facies and thermal evolution.Among them,c-1,3-dimethylcyclohexane(c-1,3DMCH)is mainly sourced from higher plants but may also form through abiotic mechanisms such as catalysis or cyclization.Theδ^(13)C values of c-1,3DMCH(δ^(13)Cc-1,3DMCH)primarily exhibit parental genetic characteristics,enabling effective distinction of oil from different source facies.Specifically,theδ^(13)Cc-1,3DMCH in marine oils,lacustrine oils,terrigenous oils,and coal-formed oils are<–22‰,from–22‰to−20.2‰,from−20.2‰to−18.4‰,and>−18.4‰,respectively.Moreover,maturity is the primary controlling factor forδ^(13)C values of 3MC7(δ^(13)C3MC7,3MC7:3-methylheptane),while the source facies serve as a secondary influence.The plot ofδ^(13)Cc-1,3DMCH andδ^(13)C3MC7 was introduced to classify source facies.Asδ^(13)Cc-1,3DMCH andδ^(13)C3MC7 increase,the source facies transits from marine to lacustrine,then terrigenous,and finally coal facies.Additionally,increasingδ^(13)C3MC7 indicates a relative increase in maturity.Therefore,theδ^(13)Cc-1,3DMCH vs.δ^(13)C3MC7 plot serves as an effective tool for distinguishing source facies and assessing relative maturity.
基金The Trùndelag Health Study (HUNT) is a collaboration between HUNT Research Centre (Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology), Trùndelag County Council, Central Norway Regional Health Authority, and the Norwegian Institute of Public HealthThe coordination of European Prospective Investigation into Cancer and Nutrition - Spain study (EPIC) is financially supported by the International Agency for Research on Cancer (IARC)+7 种基金by the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, which has additional infrastructure support provided by the NIHR Imperial Biomedical Research Centre (BRC)supported by Health Research Fund (FIS) - Instituto de Salud Carlos III (ISCIII), Regional Governments of Andaluc 1a, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology - ICO (Spain)funded by The Netherlands Organisation for Health Research and DevelopmentZon Mw (Grant No.: 531-00141-3)Funding for the SHIP study has been provided by the Federal Ministry for Education and Research (BMBFidentification codes 01 ZZ96030, 01 ZZ0103, and 01 ZZ0701)support from the Swedish Research Council (2018-02527 and 2019-00193)financed by the Helmholtz Zentrum München - German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research (BMBF) and by the State of Bavaria.
文摘Background There is insufficient evidence to provide recommendations for leisure-time physical activity among workers across various occupational physical activity levels.This study aimed to assess the association of leisure-time physical activity with cardiovascular and all-cause mortality across occupational physical activity levels.Methods This study utilized individual participant data from 21 cohort studies,comprising both published and unpublished data.Eligibility criteria included individual-level data on leisure-time and occupational physical activity(categorized as sedentary,low,moderate,and high)along with data on all-cause and/or cardiovascular mortality.A 2-stage individual participant data meta-analysis was conducted,with separate analysis of each study using Cox proportional hazards models(Stage 1).These results were combined using random-effects models(Stage 2).Results Higher leisure-time physical activity levels were associated with lower all-cause and cardiovascular mortality risk across most occupational physical activity levels,for both males and females.Among males with sedentary work,high compared to sedentary leisure-time physical activity was associated with lower all-cause(hazard ratios(HR)=0.77,95%confidence interval(95%CI):0.70-0.85)and cardiovascular mortality(HR=0.76,95%CI:0.66-0.87)risk.Among males with high levels of occupational physical activity,high compared to sedentary leisure-time physical activity was associated with lower all-cause(HR=0.84,95%CI:0.74-0.97)and cardiovascular mortality(HR=0.79,95%CI:0.60-1.04)risk,while HRs for low and moderate levels of leisure-time physical activity ranged between 0.87 and 0.97 and were not statistically significant.Among females,most effects were similar but more imprecise,especially in the higher occupational physical activity levels.Conclusion Higher levels of leisure-time physical activity were generally associated with lower mortality risks.However,results for workers with moderate and high occupational physical activity levels,especially women,were more imprecise.Our findings suggests that workers may benefit from engaging in high levels of leisure-time physical activity,irrespective of their level of occupational physical activity.
基金This is a phased research outcome of a Key Project of the National Social Science Fund of China,entitled“Research on Improving the Legal Governance System to Guarantee Social Equity and Justice”(Project Number 20AZD028).
文摘The theory of human dignity identifies certain inherent human characteristics,elevating humanity as the pinnacle of creation and valuing individuals as carriers of these traits.Under this framework,individuals are called to actively embody their human essence and participate in political life to serve the community.Overall,this interpretive paradigm of dignity establishes a distinct concept of autonomy and provides methods for its realization,fostering the secularization of politics by emphasizing human value.The doctrine of individual dignity presupposes the intrinsic worth of individuals and defends their autonomy and equal status through the imposition of legal obligations on the state.However,limited by its essentialist and communitarian orientation,the scope of autonomy and equality it provides to individuals remains constrained.By transcending ontology with a value-based approach,the concept of individual dignity creates a unique,open structure that incorporates and reflects on global human rights practices.This adaptability enables it to integrate abstract societies,advance the global human rights agenda,and critique and refine political realities.Consequently,the concept of individual dignity cannot be supplanted by the human dignity theory.
基金supported by the National Key Research and Development Program of China(2022YFC2305201)National Natural Science Foundation of China(71874168)。
文摘Objective This study aimed to investigate the prevalence of HIV pretreatment drug resistance(PDR)and the transmission clusters associated with PDR-related mutations in newly diagnosed,treatmentnaive patients between 2020 and 2023 in Dehong prefecture,Yunnan province,China.Methods Demographic information and plasma samples were collected from study participants.PDR was assessed using the Stanford HIV Drug Resistance Database.The Tamura-Nei 93 model within HIVTRACE was employed to compute pairwise matches with a genetic distance of 0.015 substitutions per site.Results Among 948 treatment-naive individuals with eligible sequences,36 HIV subtypes were identified,with unique recombinant forms(URFs)being the most prevalent(18.8%,178/948).The overall prevalence of PDR was 12.4%(118/948),and resistance to non-nucleotide reverse transcriptase inhibitors(NNRTIs),nucleotide reverse transcriptase inhibitors(NRTIs),and protease inhibitors(PIs)was10.7%,1.3%,and 1.6%,respectively.A total of 91 clusters were identified,among which eight showed evidence of PDR strain transmission.The largest PDR-associated cluster consisted of six CRF01_AE drugresistant strains carrying K103N and V179T mutations;five of these individuals had initial CD4^(+)cell counts<200 cells/μL.Conclusion The distribution of HIV subtypes in Dehong is diverse and complex.PDR was moderately prevalent(12.4%)between 2020 and 2023.Evidence of transmission of CRF01_AE strains carrying K103N and V179T mutations was found.Routine surveillance of PDR and the strengthening of control measures are essential to limit the spread of drug-resistance HIV strains.
基金supported by the National Key R&D Program of China(2020YFC2003102).
文摘Objective:To identify key factors influencing cognitive function in the elderly,including traditional Chinese medicine(TCM)constitutional classification,and to rank their relative importance.Methods:We used cross-sectional data from seven geographical regions across Chinese mainland.The Changsha version of the Montreal Cognitive Assessment was used to assess cognitive function.A“least absolute shrinkage and selection operator”(LASSO)model,multivariate linear regression analysis,and random forest(RF)model were used.Subgroup analyses were performed to examine the correlation between key TCM constitution types and cognitive function in different population subgroups.Results:A total of 24803 individuals aged 60 and above were included in the study.We selected 18 influential factors using the LASSO model.Higher education,being married,and having insurance were positively correlated with cognitive function in the elderly(all P<0.05).In contrast,poor sleep,vision impairment,hearing impairment,basic activities of daily living disability,instrumental activities of daily living disability,depression,hypertension,coronary heart disease,diabetes,stroke,yang-deficiency constitution(YADC),yin-deficiency constitution(YIDC),qi deficiency constitution(QDC),and blood stasis constitution(BSC)were negatively correlated with cognitive function(all P<0.05).YIDC and BSC affected all dimensions of cognitive function(all P<0.05).YADC mainly affected attention,language,abstraction(verbal analogies),memory,and orientation to time and place dimensions(P<0.001).QDC mainly affected language and abstraction(verbal analogies)dimensions(P<0.05).The negative correlations between BSC,YADC,YIDC,and QDC scores and cognitive function revealed statistically significant dif-ferences across most subgroups.The RF model identified education,BSC,and poor sleep quality as the three most influential factors in our study.Conclusion:BSC,YADC,YIDC,and QDC were associated with cognitive decline in the elderly.Our findings provide new perspectives and significant references for interventions for early-stage cognitive disorders.
文摘The first three months after lung transplantation are the clinical“vulnerable period”.Complications during this period often appear in the form of symptom clusters.The core includes primary graft dysfunction(PGD),infection,inflammatory response and multiple organ dysfunction,and are interconnected to form a complex network.The symptom cluster shows a clear dynamic trajectory:the risk of PGD peaks at 24 hours after surgery,and its evolution trajectory(recovery,delay,deterioration)directly affects long-term graft function;infections show a“double peak distribution”,with bacteria/fungi dominant in the early stage(<1 month)and viruses/opportunistic infections dominant in the middle stage(1-6 months),and promote each other with PGD.Influencing factors include four dimensions:donor(smoking history,infection),recipient(weakness,immune status),perioperative period(surgical method,support strategy)and postoperative management(balance of immunosuppression).In the future,dynamic prediction models and individualized management paths need to be built to improve patient outcomes.
基金supported by the National Natural Science Foundation of China(No.22372083,52201259)the National Key R&D Program of China(2021YFB2500300)+2 种基金the Fundamental Research Funds for the Central Universities:Nankai University(63241607)the Natural Science Foundation of Tianjin(No.22JCZDJC00380)the Young Elite Scientist Sponsorship Program by CAST.
文摘LiNO_(3) is known to significantly enhance the reversibility of lithium metal batteries;however,the modification of solvation structures in various solvents and its further impact on the interface have not been fully revealed.Herein,we systematically studied the evolution of solvation structures with increasing LiNO_(3) concentration in both carbonate and ether electrolytes.The results from molecular dynamics simulations unveil that the Li^(+)solvation structure is less affected in carbonate electrolytes,while in ether electrolytes,there is a significant decrease of solvent molecules in Li^(+)coordination,and a larger average size of Li^(+)solvation structure emerges as LiNO_(3) concentration increases.Notably,the formation of large ion aggregates with size of several nanometers(nano-clusters),is observed in ether-based electrolytes at conventional Li^(+)concentration(1 M)with higher NO_(3)^(-) ratio,which is further proved by infrared spectroscopy and small-angle X-ray scattering experiments.The nano-clusters with abundant anions are endowed with a narrow energy gap of molecular orbitals,contributing to the formation of an inorganic rich electrode/electrolyte interphase that enhances the reversibility of lithium stripping/plating with Coulombic efficiency up to 99.71%.The discovery of nano-clusters elucidates the underlying mechanism linking ions/solvent aggregation states of electrolytes to interfacial stability in advanced battery systems.
基金supported by a Second Century Fund Chulalongkorn University-postdoctoral fellow。
文摘Objectives:This study aimed to determine the effectiveness of an individual and family selfmanagement(IFSM)education program on triglyceride-glucose(TyG)index,self-management,and diabetes distress among adults with uncontrolled diabetes mellitus type 2(T2DM).Methods:A multicentre randomized controlled trial was employed.The study included 68 dyads(adults with uncontrolled T2DM and one family member)that were randomly allocated to the intervention(n=34)and control groups(n=34)from March to September 2024.Participants in the intervention group received an 8-week IFSM education program,whereas those in the control group received standard routine care.An automated hematology analyzer XP-100 was used to evaluate triglyceride and fasting blood glucose levels.The Diabetes Distress Scale and Diabetes Self-Management Questionnaire were used to measure diabetes distress and self-management,respectively.Results:A total of 67 participants completed the intervention.The generalized estimating equation demonstrated a significantinteraction between group and time.The IFSM education intervention group had a higher diabetes self-management(β=16.68;95%CI=15.23,18.09;P<0.001),lower diabetes distress(β=-30.74;95%CI=-32.57,-28.90;P<0.001),and lower TyG index(β=-1.97;95%CI=-2.41,-1.53;P<0.001)than the control group.Conclusions:The findingsdocumented the capacity of IFSM education to reduce TyG and diabetes distress,which could potentially escalate diabetes self-management among individuals with T2DM.
