AIM: To identify demographic and clinical factors asso-ciated with disabling Crohn's disease (CD). METHODS: A systematic review and meta-analysisof observational studies, focusing on the factors that can predict t...AIM: To identify demographic and clinical factors asso-ciated with disabling Crohn's disease (CD). METHODS: A systematic review and meta-analysisof observational studies, focusing on the factors that can predict the prognosis of different outcomes of CD was undertaken. PubMed, ISI Web of Knowledge and Scopus were searched to identify studies investigat-ing the above mentioned factors in adult patients with CD. Studies were eligible for inclusion if they describe prognostic factors in CD, with inclusion and exclusion criteria defined as follows. Studies with adult patients and CD, written in English and studying association between clinical factors and at least one prognosis out-come were included. Meta-analysis of effects was un-dertaken for the disabling disease outcome, using odds ratio (OR) to assess the effect of the different factors in the outcome. The statistical method used was Mantel-Haenszel for fixed effects. The 16-item quality assess-ment tool (QATSDD) was used to assess the quality of the studies (range: 0-42). RESULTS: Of the 913 papers initially selected, sixty studies were reviewed and three were included in the systematic review and meta-analysis. The global QA-TSDD scores of papers were 18, 21 and 22. Of a total of 1961 patients enrolled, 1332 (78%) were classified with disabling disease five years after diagnosis. In two studies, age at diagnosis was a factor associated with disabling disease five years after diagnosis. Individu-als under 40 years old had a higher risk of developing disabling disease. In two studies, patients who were treated with corticosteroids on the first flare developed disabling disease five years after diagnosis. Further, perianal disease was found to be relevant in all of the studies at two and five years after diagnosis. Finally, one study showed localization as a factor associated with disabling disease five years after diagnosis, with L3 being a higher risk factor. This meta-analysis showed a significantly higher risk of developing disabling dis-ease at five years after initial diagnosis among patients younger than 40 years of age (OR=2.47, 95%CI: 1.74-3.51), with initial steroid treatment for first flare (OR=2.42, 95%CI: 1.87-3.11) and with perianal dis-ease (OR = 2.00, 95%CI: 1.41-2.85).CONCLUSION: Age at diagnosis, perianal disease, ini-tial use of steroids and localization seem to be indepen-dent prognostic factors of disabling disease.展开更多
Background：The awareness,treatment and prevention of chronic diseases are generally poor among the elderly population of China,whereas the prevention and control of chronic diseases in elderly veteran communities hav...Background：The awareness,treatment and prevention of chronic diseases are generally poor among the elderly population of China,whereas the prevention and control of chronic diseases in elderly veteran communities have been ongoing for more than 30 years.Therefore,investigating the awareness status of chronic disabling neurological diseases （CDND） and common chronic diseases （CCD） among elderly veterans may provide references for related programs among the elderly in the general population.Methods：A cross-sectional survey was conducted among veterans ≥60 years old in veteran communities in Beijing.The awareness of preventive strategies against dementia,Alzheimer＆#39;s disease （AD）,Parkinson＆#39;s disease （PD）,sleep disorders,cerebrovascular disease （CVD） and CCD such as hypertension,and the approaches used to access this information,including media,word of mouth （verbal communication among the elderly） and health care professionals,were investigated via face-to-face interviews.Results：The awareness rates for CCD and CVD were approximately 100%,but that forAD was the lowest at 〈10%.The awareness rates for sleep disorders,PD and dementia,were 51.0-89.4%.Media was the most commonly selected mode of communication by which veterans acquired knowledge about CCD and CVD.Media was used by approximately 80% of veterans.Both health care professionals and word of mouth were used by approximately 50% of veterans.With respect to the source of information about CDND excluding AD,the rates of the use of health care professionals,word of mouth and media were 10.6-28.2%,56.5-76.5%,and approximately 50%,respectively.Conclusions：The awareness of CDND among elderly veterans was significantly lower than that of CCD.More information about CDND should be disseminated by health care professionals.Appropriate guidance will promote the rapid and extensive dissemination of information about the prevention of CDND by media and word-of-mouth peer education.展开更多
Chronic pain and disability following acute orthopedic trauma are not only physical concerns but also deeply intertwined with psychological well-being.The recent retrospective cohort study by Yang et al,published,prov...Chronic pain and disability following acute orthopedic trauma are not only physical concerns but also deeply intertwined with psychological well-being.The recent retrospective cohort study by Yang et al,published,provides compelling evidence of significant associations between depression,anxiety,and postoperative recovery.These findings align with an expanding body of literature that confirms the need for orthopedic rehabilitation to adopt a biopsychosocial perspective.This letter contextualizes Yang et al’s study within current evidence,highlighting the roles of sleep disturbance,catastrophizing,stress,neurobiological mechanisms,and coping strategies in shaping recovery.It further emphasizes the importance of integrating nursing-led and multidisciplinary interventions to address both physical and psychological domains,ultimately promoting holistic recovery.展开更多
Background:Low relative sit-to-stand(STS)power has emerged as a critical predictor of adverse health outcomes,such as frailty and disability,in older adults.However,its impact on falls,fractures,hospitalizations,and a...Background:Low relative sit-to-stand(STS)power has emerged as a critical predictor of adverse health outcomes,such as frailty and disability,in older adults.However,its impact on falls,fractures,hospitalizations,and all-cause mortality remains unclear.Therefore,this longitudinal study aimed to investigate the potential associations between low relative STS power and these adverse health outcomes in older adults.Methods:A total of 1876 older adults(aged≥65 years,56.4%women)were included from the Toledo Study for Healthy Aging.Relative STS power was assessed using the 30-s STS test and the Alcazar equation.Participants were categorized as having low relative STS power based on previously established cut-off points(2.53 W/kg for men and 2.01 W/kg for women).Falls and fractures(hip and all-type)within the previous year were recorded.Hospitalizations and all-cause mortality were obtained during a follow-up of 6.8±3.1 years(mean±SD;median=7.8 years;interquartile range:3.9-10.1 years)and 9.7±3.5 years(median=10.9 years;interquartile range:8.2-12.5 years),respectively.Generalized linear mixed models,binary logistic regression,and proportional hazards regression adjusted for age,educational level,and comorbidities were used.Results:In men,low relative STS power was significantly associated with an increased likelihood of history of falls(odds ratio(OR)=1.73,95%confidence interval(95%CI):1.08-2.75,p=0.022)and all-type fractures(OR=1.86,95%CI:1.21-2.84,p=0.004)in the previous year.In women,low relative STS power was associated with a higher probability of hip fractures within the previous year(OR=3.25,95%CI:1.07-9.86,p=0.038).Low relative STS power predicted hospitalizations in women(hazard ratio(HR)=1.29,95%CI:1.06-1.58,p=0.012)and longer hospital stays in both men(p=0.020)and women(p=0.033).Low relative STS power significantly increased all-cause mortality in both men(HR=1.57,95%CI:1.26-1.97,p<0.001)and women(HR=2.04,95%CI:1.51-2.74,p<0.001).Conclusion:Low relative STS power was associated with history of hip fractures in women,whereas in men it was associated with history of falls and all-type fractures.Low relative STS power predicted hospitalizations in women but not in men.In both men and women,low relative STS power was associated with longer hospital stays and increased risk of all-cause mortality.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
This report presents a forensic evaluation of a case involving blindness(visual acuity grade 5)following a bee/wasp sting to the left eye.Through systematic analysis of the patient’s multiple hospital admissions,post...This report presents a forensic evaluation of a case involving blindness(visual acuity grade 5)following a bee/wasp sting to the left eye.Through systematic analysis of the patient’s multiple hospital admissions,postoperative follow-up data,and a review of the pathological mechanisms of ocular injury caused by bee venom,this study comprehensively assesses the injury characteristics,treatment course,and visual outcomes.Bee venom induces severe complications such as corneal damage,uveitis,cataract,and secondary glaucoma through multiple mechanisms including direct cytotoxicity,immune-inflammatory responses,and enzymatic hydrolysis.Despite interventions including anterior chamber irrigation,phacoemulsification with intraocular lens implantation,and antiglaucoma surgery,the affected eye ultimately lost light perception.Forensic examination confirmed the absence of light perception in the left eye and abnormal visual pathway function,consistent with clinical observations.According to the relevant Chinese disability assessment standard(JR/T 0083-2013,Article 4.2.2),the injury was classified as grade 7 disability.This study provides an in-depth discussion of the mechanisms and key forensic identification points in bee-sting-induced blindness,offering a scientific reference for similar forensic clinical cases.展开更多
This study investigated the effects of parental involvement,parenting stress,and social support on the social skills of school-aged children(6-18 years old)with intellectual disabilities(ID).Data were collected from 2...This study investigated the effects of parental involvement,parenting stress,and social support on the social skills of school-aged children(6-18 years old)with intellectual disabilities(ID).Data were collected from 280 Chinese parents(mothers=70.0%,fathers=30.0%)of children with ID through purposive sampling and analyzed using partial least squares structural equation modeling(PLS-SEM).The results indicated that parental involvement not only directly enhanced children’s social skills but also indirectly improved them by alleviating parenting stress,which acted as a partial mediator.Contrary to the stress-buffering hypothesis,social support did not moderate the negative impact of parenting stress on social skills.Theoretically,this study contributes by validating ecological systems theory through a shift in focus from individual deficits to family systems,while also challenging the conventional view of stress-buffering theory.Accordingly,parent-support programs should integrate practical involvement training with systematic stress reduction and provide tailored assistance such as behavior-management training and respite care.展开更多
Hebei Province has incorporated targeted assistance services for people with disabilities into livelihood projects,upgrading the quality and efficiency of support services for disadvantaged groups.THE living and nursi...Hebei Province has incorporated targeted assistance services for people with disabilities into livelihood projects,upgrading the quality and efficiency of support services for disadvantaged groups.THE living and nursing allowances provided by the Chinese government for people with disabilities who are unable to work are not only important components of China’s social security system which provide for the needs of its disabled,but also show China’s ability to guarantee the basic living standard and social fairness and justice for this group of people.展开更多
Pioneering initiatives in Yunnan Province are leveraging intangible cultural heritage to foster practical skills and create flexible employment,opening a sustainable path to prosperity and rural revitalization for peo...Pioneering initiatives in Yunnan Province are leveraging intangible cultural heritage to foster practical skills and create flexible employment,opening a sustainable path to prosperity and rural revitalization for people with disabilities.ACROSS China,provinces and municipalities have adopted a range of initiatives,based on local conditions to facilitate employment for people with disabilities.In southwest China’s Yunnan Province,home to many ethnic minorities,efforts have focused on integrating employment for disabled people with rural revitalization.展开更多
Background:China accounts for one-quarter of the world’s diabetes population,with significant subnational disparities.However,none of the available data have provided comprehensive estimates and projections at both r...Background:China accounts for one-quarter of the world’s diabetes population,with significant subnational disparities.However,none of the available data have provided comprehensive estimates and projections at both regional and national levels in diabetes prevention and management.This study aimed to explore the temporal trends and geographical variations in the prevalence and non-fatal burden of diabetes by age and sex across China from 2005 to 2023,and to forecast diabetes prevalence through 2050.Methods:We conducted a population-based study based on the nationally representative surveys,and literature reviews.Using the DisMod-MR model and Chinese-specific disease disability weights,we estimated the non-fatal burdens of diabetes,including prevalence and years lived with disability(YLDs),across sexes,age groups,and locations.The temporal trend change was measured as the average annual percent change.The effect of the human development index on burdens was assessed by applying Spearman’s rank correlation analysis.We further projected diabetes prevalence to 2050 under 2 scenarios,the natural trend and the effective intervention on body mass index(BMI).Results:In 2023,an estimated 233 million individuals in China were living with diabetes.Compared to 2005,the agestandardized rate(ASR)of prevalence has increased by nearly 50%,from 7.53%(95%CI 7.00-8.10)to 13.7%(95%CI 12.6-14.8)in 2023.The ASR of YLDs was estimated at 19.1 per 1000 population(95%CI 18.6-19.5)in 2023,compared to 10.5 per 1000 population in 2005.The ASR of prevalence and YLDs was consistently higher in males than in females.The provinces with the highest diabetes prevalence and disease burden were Beijing,Tianjin,and Shanghai.Our forecast results suggest that if existing trends continue,the prevalence of obesity will reach 29.1%(95%CI 22.2-38.2)nationally by 2050,with some provinces in the northern region observing a prevalence of over 40%.Conversely,if effective obesity interventions were implemented,the growth in diabetes prevalence could potentially be suppressed by nearly 50%.Conclusions:The health burden and economic cost associated with diabetes are profound.There is an urgent need to scale up preventive efforts and improve population awareness to enhance disease management and achieve optimal treatment outcomes.展开更多
The protein connector enhancer of kinase suppressor of Ras 2(CNKSR2),present in both the postsynaptic density and cytoplasm of neurons,is a scaffolding protein with several protein-binding domains.Variants of the CNKS...The protein connector enhancer of kinase suppressor of Ras 2(CNKSR2),present in both the postsynaptic density and cytoplasm of neurons,is a scaffolding protein with several protein-binding domains.Variants of the CNKSR2 gene have been implicated in neurodevelopmental disorders,particularly intellectual disability,although the precise mechanism involved has not yet been fully understood.Research has demonstrated that CNKSR2 plays a role in facilitating the localization of postsynaptic density protein complexes to the membrane,thereby influencing synaptic signaling and the morphogenesis of dendritic spines.However,the function of CNKSR2 in the cytoplasm remains to be elucidated.In this study,we used immunoprecipitation and high-resolution liquid chromatography-mass spectrometry to identify the interactors of CNKSR2.Through a combination of bioinformatic analysis and cytological experiments,we found that the CNKSR2 interactors were significantly enriched in the proteome of the centrosome.We also showed that CNKSR2 interacted with the microtubule protein DYNC1H1 and with the centrosome marker CEP290.Subsequent colocalization analysis confirmed the centrosomal localization of CNKSR2.When we downregulated CNKSR2 expression in mouse neuroblastoma cells(Neuro 2A),we observed significant changes in the expression of numerous centrosomal genes.This manipulation also affected centrosome-related functions,including cell size and shape,cell proliferation,and motility.Furthermore,we found that CNKSR2 interactors were highly enriched in de novo variants associated with intellectual disability and autism spectrum disorder.Our findings establish a connection between CNKSR2 and the centrosome,and offer new insights into the underlying mechanisms of neurodevelopmental disorders.展开更多
Degenerative cervical myelopathy is a common cause of spinal cord injury,with longer symptom duration and higher myelopathy severity indicating a worse prognosis.While numerous studies have investigated serological bi...Degenerative cervical myelopathy is a common cause of spinal cord injury,with longer symptom duration and higher myelopathy severity indicating a worse prognosis.While numerous studies have investigated serological biomarkers for acute spinal cord injury,few studies have explored such biomarkers for diagnosing degenerative cervical myelopathy.This study involved 30 patients with degenerative cervical myelopathy(51.3±7.3 years old,12 women and 18 men),seven healthy controls(25.7±1.7 years old,one woman and six men),and nine patients with cervical spondylotic radiculopathy(51.9±8.6 years old,three women and six men).Analysis of blood samples from the three groups showed clear differences in transcriptomic characteristics.Enrichment analysis identified 128 differentially expressed genes that were enriched in patients with neurological disabilities.Using least absolute shrinkage and selection operator analysis,we constructed a five-gene model(TBCD,TPM2,PNKD,EIF4G2,and AP5Z1)to diagnose degenerative cervical myelopathy with an accuracy of 93.5%.One-gene models(TCAP and SDHA)identified mild and severe degenerative cervical myelopathy with accuracies of 83.3%and 76.7%,respectively.Signatures of two immune cell types(memory B cells and memory-activated CD4^(+)T cells)predicted levels of lesions in degenerative cervical myelopathy with 80%accuracy.Our results suggest that peripheral blood RNA biomarkers could be used to predict lesion severity in degenerative cervical myelopathy.展开更多
Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing up.These normal experiences are potentially magnified for teenagers living with chronic ...Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing up.These normal experiences are potentially magnified for teenagers living with chronic illness or disability and their families.Advances in care have improved survival for children with a variety of serious chronic medical conditions such that many who may once have died in childhood now survive well into adulthood with ongoing morbidity.For those with highly complex needs,care is often provided at major paediatric hospitals with expertise,specially trained personnel,and resources to support young people and their families for the first decades of life.At the end of adolescence,however,it is generally appropriate and necessary for young adults and their caregivers to transition to the care of clinicians trained in the care of adults at general hospitals.While there are some well-managed models to support this journey of transition,these are often specific to certain conditions and usually do not involve intensive care.Many patients may encounter considerable challenges during this period.Difficulties may include the loss of established therapeutic relationships,a perception of austerity and reduced amenity in facilities oriented to caring for adult patients,and care by clinicians with less experience with more common paediatric conditions.In addition,there is a risk of potential conflict between clinicians and families regarding goals of care in the event of a critical illness when it occurs in a young adult with major disability and long-term health issues.These challenges present genuine opportunities to better understand the transition from paediatric to adult-based care and to improve processes that assist clinicians who support patients and families as they shift between healthcare settings.展开更多
In 1993,the World Bank released a global report on the efficacy of health promotion,introducing the disability-adjusted life years(DALY)as a novel indicator.The DALY,a composite metric incorporating temporal and quali...In 1993,the World Bank released a global report on the efficacy of health promotion,introducing the disability-adjusted life years(DALY)as a novel indicator.The DALY,a composite metric incorporating temporal and qualitative data,is grounded in preferences regarding disability status.This review delineates the algorithm used to calculate the value of the proposed DALY synthetic indicator and elucidates key methodological challenges associated with its application.In contrast to the quality-adjusted life years approach,derived from multi-attribute utility theory,the DALY stands as an independent synthetic indicator that adopts the assumptions of the Time Trade Off utility technique to define Disability Weights.Claiming to rely on no mathematical or economic theory,DALY users appear to have exempted themselves from verifying whether this indicator meets the classical properties required of all indicators,notably content validity,reliability,specificity,and sensitivity.The DALY concept emerged primarily to facilitate comparisons of the health impacts of various diseases globally within the framework of the Global Burden of Disease initiative,leading to numerous publications in international literature.Despite widespread adoption,the DALY synthetic indicator has prompted significant methodological concerns since its inception,manifesting in inconsistent and non-reproducible results.Given the substantial diffusion of the DALY indicator and its critical role in health impact assessments,a reassessment is warranted.This reconsideration is imperative for enhancing the robustness and reliability of public health decisionmaking processes.展开更多
Photos of a 31‑year‑old man carrying his mother on his back at Tiananmen Square went viral on Chinese social media,drawing the praise of millions around the country,but Xiao Ma has been carrying his disabled mother fo...Photos of a 31‑year‑old man carrying his mother on his back at Tiananmen Square went viral on Chinese social media,drawing the praise of millions around the country,but Xiao Ma has been carrying his disabled mother for years and documenting their travels through short videos.展开更多
Burden of disease research plays a pivotal role in global and national health policy by quantifying the impact of illnesses, injuries, and risk factors on populations. Through metrics such as disabilityadjusted life y...Burden of disease research plays a pivotal role in global and national health policy by quantifying the impact of illnesses, injuries, and risk factors on populations. Through metrics such as disabilityadjusted life years (DALYs), years of life lost (YLLs),and years lived with disability (YLDs), it provides a comprehensive assessment of health loss, enabling evidence-based decision-making[1].展开更多
BACKGROUND The occurrence of chronic pain and disability after acute orthopedic trauma is significantly correlated with psychological factors,particularly depression and anxiety.As such,assessment of these factors is ...BACKGROUND The occurrence of chronic pain and disability after acute orthopedic trauma is significantly correlated with psychological factors,particularly depression and anxiety.As such,assessment of these factors is crucial for postoperative rehabilitation.AIM To investigate the correlation between chronic pain,disability,and psychological factors(depression and anxiety)after acute orthopedic trauma surgery.METHODS Data from 120 patients,who underwent surgery for acute orthopedic trauma at Xi’an Traditional Chinese Medicine Hospital(Shaanxi Province,China)between June 2022 and June 2024,were retrospectively analyzed.Basic information and postoperative pain metrics[visual analog scale(VAS)],disability rating index(DRI),Hamilton anxiety rating scale(HAMA)and Hamilton depression rating scale(HAMD)were collected from electronic medical records.Pearson’s correlation analysis was used to examine associations between chronic pain VAS,DRI,HAMD,and HAMA scores.RESULTS Among the 120 patients[79(65.8%)males and 41(34.2%)females],postoperative VAS scores were significantly associated with HAMD and HAMA scores,with correlation coefficients of 0.625(P=0.027)and 0.568(P<0.001),respectively.Postoperative DRI scores were also significantly associated with HAMD and HAMA scores,with correlation coefficients of 0.683 and 0.557,respectively(both P<0.001).CONCLUSION Chronic pain and disability after surgery for acute orthopedic trauma are significantly correlated with psychological factors(depression and anxiety).Multidisciplinary teams should integrate mental health services to improve patient outcomes.展开更多
Introduction: Stroke may have a negative impact on mental health and behavior. Cognitive disorders are common after stroke. They are rarely assessed in current clinical practice, particularly in our context. They cons...Introduction: Stroke may have a negative impact on mental health and behavior. Cognitive disorders are common after stroke. They are rarely assessed in current clinical practice, particularly in our context. They constitute a real “invisible” handicap. In sub-Saharan Africa, we are not aware of any studies specifically assessing executive functions. These functions are at the heart of all adaptation processes to new or complex situations. This prompted the authors to carry out this study at the Ibrahima Pierre Ndiaye Neuroscience Department of the Fann National University Hospital Centre (Senegal). Objective and Methodology: The aim of this study was to assess and characterize post-stroke alterations in executive functions in our context. We conducted a descriptive cross-sectional study. It took place over a 4-month period from April 1 to August 31, 2021. Patients were matched to controls according to age, gender and educational level. Executive functions were assessed using the Frontal Assessment Battery (FAB). Results: A total of 30 patients with stroke were enrolled. These patients were matched to controls. The mean age of the patients was 46.87 ± 17.65 years. For the control group, it was 39.27 ± 12.33 years. The prevalence of executive function disorders was 20% in post-stroke patients. The majority of executive functions assessed were impaired. Sensitivity to interference and environmental autonomy were the only ones preserved. Conclusion: Impaired executive functions are common after stroke. They should be systematically assessed in all stroke patients to ensure optimal management.展开更多
Total hip arthroplasty(THA)effectively treats advanced hip disorders,yet outcomes vary among patients.Frailty has become a crucial factor influencing these results.Several studies explored multiple preoperative factor...Total hip arthroplasty(THA)effectively treats advanced hip disorders,yet outcomes vary among patients.Frailty has become a crucial factor influencing these results.Several studies explored multiple preoperative factors affecting THA outcomes,highlighting the significance of age,Western Ontario and Mc-Master Universities Osteoarthritis Index,Center for Epidemiologic Studies Depression Scale,and central sensitization index scores in predicting post-operative recovery,emphasizing comprehensive preoperative assessments.Subsequent research has shown that frailty,measured by tools like the hospital frailty risk score and frailty deficit index,is significantly associated with adverse outcomes such as higher 30-day readmission rates,longer hospital stays,increased costs,and elevated mortality and complication risks in both primary and revision THA.Additionally,frailty related to short-term adverse events but stressed the need for standardized frailty measurement.Currently,there is no unified standard for assessing frailty before THA,which hinders cross-study comparison and evidence-based guideline development.Future research should focus on establishing a universal frailty assessment standard considering physical function,comorbidities,cognitive and psychological status.Prospective studies are also needed to clarify the causal relationship between frailty and long-term THA outcomes and identify modifiable factors for preoperative interventions.Overall,understanding the impact of frailty on THA outcomes is essential for improving patient care and resource utilization,especially in an aging population with a rising prevalence of hip disorders.展开更多
Since the 1970s,a series of international and national sources have supported the principle of accessibility,which slowly has become a statuary norm and a legislative obligation.Each country has implemented accessibil...Since the 1970s,a series of international and national sources have supported the principle of accessibility,which slowly has become a statuary norm and a legislative obligation.Each country has implemented accessibility through a singular policy.But in addition to the accessibility of a place or an activity,to inform about what is accessible is very important as well,and has not really taken off.Indeed,for disabled people,the difficulty lies not only with access to places and the use of resources,but also with the visibility of these resources.This means that information concerning accessibility has to be disclosed and provided effectively to disabled people,those involved with them and the relevant institutions.In different countries all over the world,many labels and pictograms have been created for this purpose and give information relating to accessibility.Using a socio-historical approach,we will present and analyze the different types of icons,symbols,pictograms and labels that have been put in place around the world and in France:what are they used for and for whom are they made?We will show that they are pointers which firstly reflect the diversity and range within the target group concerned by accessibility,and secondly the evolution of accessibility as a dynamic and ecological principle.展开更多
基金Supported by Centre for Research in Health Informatics Systems and Technologies(CINTESIS)
文摘AIM: To identify demographic and clinical factors asso-ciated with disabling Crohn's disease (CD). METHODS: A systematic review and meta-analysisof observational studies, focusing on the factors that can predict the prognosis of different outcomes of CD was undertaken. PubMed, ISI Web of Knowledge and Scopus were searched to identify studies investigat-ing the above mentioned factors in adult patients with CD. Studies were eligible for inclusion if they describe prognostic factors in CD, with inclusion and exclusion criteria defined as follows. Studies with adult patients and CD, written in English and studying association between clinical factors and at least one prognosis out-come were included. Meta-analysis of effects was un-dertaken for the disabling disease outcome, using odds ratio (OR) to assess the effect of the different factors in the outcome. The statistical method used was Mantel-Haenszel for fixed effects. The 16-item quality assess-ment tool (QATSDD) was used to assess the quality of the studies (range: 0-42). RESULTS: Of the 913 papers initially selected, sixty studies were reviewed and three were included in the systematic review and meta-analysis. The global QA-TSDD scores of papers were 18, 21 and 22. Of a total of 1961 patients enrolled, 1332 (78%) were classified with disabling disease five years after diagnosis. In two studies, age at diagnosis was a factor associated with disabling disease five years after diagnosis. Individu-als under 40 years old had a higher risk of developing disabling disease. In two studies, patients who were treated with corticosteroids on the first flare developed disabling disease five years after diagnosis. Further, perianal disease was found to be relevant in all of the studies at two and five years after diagnosis. Finally, one study showed localization as a factor associated with disabling disease five years after diagnosis, with L3 being a higher risk factor. This meta-analysis showed a significantly higher risk of developing disabling dis-ease at five years after initial diagnosis among patients younger than 40 years of age (OR=2.47, 95%CI: 1.74-3.51), with initial steroid treatment for first flare (OR=2.42, 95%CI: 1.87-3.11) and with perianal dis-ease (OR = 2.00, 95%CI: 1.41-2.85).CONCLUSION: Age at diagnosis, perianal disease, ini-tial use of steroids and localization seem to be indepen-dent prognostic factors of disabling disease.
文摘Background：The awareness,treatment and prevention of chronic diseases are generally poor among the elderly population of China,whereas the prevention and control of chronic diseases in elderly veteran communities have been ongoing for more than 30 years.Therefore,investigating the awareness status of chronic disabling neurological diseases （CDND） and common chronic diseases （CCD） among elderly veterans may provide references for related programs among the elderly in the general population.Methods：A cross-sectional survey was conducted among veterans ≥60 years old in veteran communities in Beijing.The awareness of preventive strategies against dementia,Alzheimer＆#39;s disease （AD）,Parkinson＆#39;s disease （PD）,sleep disorders,cerebrovascular disease （CVD） and CCD such as hypertension,and the approaches used to access this information,including media,word of mouth （verbal communication among the elderly） and health care professionals,were investigated via face-to-face interviews.Results：The awareness rates for CCD and CVD were approximately 100%,but that forAD was the lowest at 〈10%.The awareness rates for sleep disorders,PD and dementia,were 51.0-89.4%.Media was the most commonly selected mode of communication by which veterans acquired knowledge about CCD and CVD.Media was used by approximately 80% of veterans.Both health care professionals and word of mouth were used by approximately 50% of veterans.With respect to the source of information about CDND excluding AD,the rates of the use of health care professionals,word of mouth and media were 10.6-28.2%,56.5-76.5%,and approximately 50%,respectively.Conclusions：The awareness of CDND among elderly veterans was significantly lower than that of CCD.More information about CDND should be disseminated by health care professionals.Appropriate guidance will promote the rapid and extensive dissemination of information about the prevention of CDND by media and word-of-mouth peer education.
文摘Chronic pain and disability following acute orthopedic trauma are not only physical concerns but also deeply intertwined with psychological well-being.The recent retrospective cohort study by Yang et al,published,provides compelling evidence of significant associations between depression,anxiety,and postoperative recovery.These findings align with an expanding body of literature that confirms the need for orthopedic rehabilitation to adopt a biopsychosocial perspective.This letter contextualizes Yang et al’s study within current evidence,highlighting the roles of sleep disturbance,catastrophizing,stress,neurobiological mechanisms,and coping strategies in shaping recovery.It further emphasizes the importance of integrating nursing-led and multidisciplinary interventions to address both physical and psychological domains,ultimately promoting holistic recovery.
基金supported by Centro de Investigaci on Biom edica en Red Fragilidad y Envejecimiento Saludable(CIBERFES)(Grant Nos.CB16/10/00477,CB16/10/00456,and CB16/10/00464)Plan Propio de Investigaci on of the University of Castilla-La Mancha,and Fondo Europeo de Desarrollo Regional(FEDER)funds from the European Union(Grant No.2022-GRIN-34296)+3 种基金further funded by grants from the Instituto de Salud Carlos III(Grant Nos.PI031558,PI07/90637,PI07/90306,RD 06/0013,and PI18/00972)the Government of Castilla-La Mancha(Grant Nos.03031 and SBPLY/19/180501/000312)Red EXERNETRED DE EJERCICIO FISICO Y SALUD:RED2022-134800T from the Spanish Ministry of Innovation and Sciencesupported by a research grant from the University of Castilla-La Mancha(Programa Investigo,Grant No.2024INVGO-12359)。
文摘Background:Low relative sit-to-stand(STS)power has emerged as a critical predictor of adverse health outcomes,such as frailty and disability,in older adults.However,its impact on falls,fractures,hospitalizations,and all-cause mortality remains unclear.Therefore,this longitudinal study aimed to investigate the potential associations between low relative STS power and these adverse health outcomes in older adults.Methods:A total of 1876 older adults(aged≥65 years,56.4%women)were included from the Toledo Study for Healthy Aging.Relative STS power was assessed using the 30-s STS test and the Alcazar equation.Participants were categorized as having low relative STS power based on previously established cut-off points(2.53 W/kg for men and 2.01 W/kg for women).Falls and fractures(hip and all-type)within the previous year were recorded.Hospitalizations and all-cause mortality were obtained during a follow-up of 6.8±3.1 years(mean±SD;median=7.8 years;interquartile range:3.9-10.1 years)and 9.7±3.5 years(median=10.9 years;interquartile range:8.2-12.5 years),respectively.Generalized linear mixed models,binary logistic regression,and proportional hazards regression adjusted for age,educational level,and comorbidities were used.Results:In men,low relative STS power was significantly associated with an increased likelihood of history of falls(odds ratio(OR)=1.73,95%confidence interval(95%CI):1.08-2.75,p=0.022)and all-type fractures(OR=1.86,95%CI:1.21-2.84,p=0.004)in the previous year.In women,low relative STS power was associated with a higher probability of hip fractures within the previous year(OR=3.25,95%CI:1.07-9.86,p=0.038).Low relative STS power predicted hospitalizations in women(hazard ratio(HR)=1.29,95%CI:1.06-1.58,p=0.012)and longer hospital stays in both men(p=0.020)and women(p=0.033).Low relative STS power significantly increased all-cause mortality in both men(HR=1.57,95%CI:1.26-1.97,p<0.001)and women(HR=2.04,95%CI:1.51-2.74,p<0.001).Conclusion:Low relative STS power was associated with history of hip fractures in women,whereas in men it was associated with history of falls and all-type fractures.Low relative STS power predicted hospitalizations in women but not in men.In both men and women,low relative STS power was associated with longer hospital stays and increased risk of all-cause mortality.
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This report presents a forensic evaluation of a case involving blindness(visual acuity grade 5)following a bee/wasp sting to the left eye.Through systematic analysis of the patient’s multiple hospital admissions,postoperative follow-up data,and a review of the pathological mechanisms of ocular injury caused by bee venom,this study comprehensively assesses the injury characteristics,treatment course,and visual outcomes.Bee venom induces severe complications such as corneal damage,uveitis,cataract,and secondary glaucoma through multiple mechanisms including direct cytotoxicity,immune-inflammatory responses,and enzymatic hydrolysis.Despite interventions including anterior chamber irrigation,phacoemulsification with intraocular lens implantation,and antiglaucoma surgery,the affected eye ultimately lost light perception.Forensic examination confirmed the absence of light perception in the left eye and abnormal visual pathway function,consistent with clinical observations.According to the relevant Chinese disability assessment standard(JR/T 0083-2013,Article 4.2.2),the injury was classified as grade 7 disability.This study provides an in-depth discussion of the mechanisms and key forensic identification points in bee-sting-induced blindness,offering a scientific reference for similar forensic clinical cases.
文摘This study investigated the effects of parental involvement,parenting stress,and social support on the social skills of school-aged children(6-18 years old)with intellectual disabilities(ID).Data were collected from 280 Chinese parents(mothers=70.0%,fathers=30.0%)of children with ID through purposive sampling and analyzed using partial least squares structural equation modeling(PLS-SEM).The results indicated that parental involvement not only directly enhanced children’s social skills but also indirectly improved them by alleviating parenting stress,which acted as a partial mediator.Contrary to the stress-buffering hypothesis,social support did not moderate the negative impact of parenting stress on social skills.Theoretically,this study contributes by validating ecological systems theory through a shift in focus from individual deficits to family systems,while also challenging the conventional view of stress-buffering theory.Accordingly,parent-support programs should integrate practical involvement training with systematic stress reduction and provide tailored assistance such as behavior-management training and respite care.
文摘Hebei Province has incorporated targeted assistance services for people with disabilities into livelihood projects,upgrading the quality and efficiency of support services for disadvantaged groups.THE living and nursing allowances provided by the Chinese government for people with disabilities who are unable to work are not only important components of China’s social security system which provide for the needs of its disabled,but also show China’s ability to guarantee the basic living standard and social fairness and justice for this group of people.
文摘Pioneering initiatives in Yunnan Province are leveraging intangible cultural heritage to foster practical skills and create flexible employment,opening a sustainable path to prosperity and rural revitalization for people with disabilities.ACROSS China,provinces and municipalities have adopted a range of initiatives,based on local conditions to facilitate employment for people with disabilities.In southwest China’s Yunnan Province,home to many ethnic minorities,efforts have focused on integrating employment for disabled people with rural revitalization.
基金supported by the National Key Research and Development Program of China(2023YFC3605000).
文摘Background:China accounts for one-quarter of the world’s diabetes population,with significant subnational disparities.However,none of the available data have provided comprehensive estimates and projections at both regional and national levels in diabetes prevention and management.This study aimed to explore the temporal trends and geographical variations in the prevalence and non-fatal burden of diabetes by age and sex across China from 2005 to 2023,and to forecast diabetes prevalence through 2050.Methods:We conducted a population-based study based on the nationally representative surveys,and literature reviews.Using the DisMod-MR model and Chinese-specific disease disability weights,we estimated the non-fatal burdens of diabetes,including prevalence and years lived with disability(YLDs),across sexes,age groups,and locations.The temporal trend change was measured as the average annual percent change.The effect of the human development index on burdens was assessed by applying Spearman’s rank correlation analysis.We further projected diabetes prevalence to 2050 under 2 scenarios,the natural trend and the effective intervention on body mass index(BMI).Results:In 2023,an estimated 233 million individuals in China were living with diabetes.Compared to 2005,the agestandardized rate(ASR)of prevalence has increased by nearly 50%,from 7.53%(95%CI 7.00-8.10)to 13.7%(95%CI 12.6-14.8)in 2023.The ASR of YLDs was estimated at 19.1 per 1000 population(95%CI 18.6-19.5)in 2023,compared to 10.5 per 1000 population in 2005.The ASR of prevalence and YLDs was consistently higher in males than in females.The provinces with the highest diabetes prevalence and disease burden were Beijing,Tianjin,and Shanghai.Our forecast results suggest that if existing trends continue,the prevalence of obesity will reach 29.1%(95%CI 22.2-38.2)nationally by 2050,with some provinces in the northern region observing a prevalence of over 40%.Conversely,if effective obesity interventions were implemented,the growth in diabetes prevalence could potentially be suppressed by nearly 50%.Conclusions:The health burden and economic cost associated with diabetes are profound.There is an urgent need to scale up preventive efforts and improve population awareness to enhance disease management and achieve optimal treatment outcomes.
基金supported by the National Nature Science Foundation of China,No.32101020(to JL)the Natural Science Foundation of Shandong Province,Nos.ZR2020MC071(to JL),ZR2023MH327(to HZ)+1 种基金the Integrated Project of Major Research Plan of National Natural Science Foundation of China,No.92249303(to PL)the Natural Science Foundation of Qingdao,No.23-2-1-193-zyyd-jch(to HZ)。
文摘The protein connector enhancer of kinase suppressor of Ras 2(CNKSR2),present in both the postsynaptic density and cytoplasm of neurons,is a scaffolding protein with several protein-binding domains.Variants of the CNKSR2 gene have been implicated in neurodevelopmental disorders,particularly intellectual disability,although the precise mechanism involved has not yet been fully understood.Research has demonstrated that CNKSR2 plays a role in facilitating the localization of postsynaptic density protein complexes to the membrane,thereby influencing synaptic signaling and the morphogenesis of dendritic spines.However,the function of CNKSR2 in the cytoplasm remains to be elucidated.In this study,we used immunoprecipitation and high-resolution liquid chromatography-mass spectrometry to identify the interactors of CNKSR2.Through a combination of bioinformatic analysis and cytological experiments,we found that the CNKSR2 interactors were significantly enriched in the proteome of the centrosome.We also showed that CNKSR2 interacted with the microtubule protein DYNC1H1 and with the centrosome marker CEP290.Subsequent colocalization analysis confirmed the centrosomal localization of CNKSR2.When we downregulated CNKSR2 expression in mouse neuroblastoma cells(Neuro 2A),we observed significant changes in the expression of numerous centrosomal genes.This manipulation also affected centrosome-related functions,including cell size and shape,cell proliferation,and motility.Furthermore,we found that CNKSR2 interactors were highly enriched in de novo variants associated with intellectual disability and autism spectrum disorder.Our findings establish a connection between CNKSR2 and the centrosome,and offer new insights into the underlying mechanisms of neurodevelopmental disorders.
基金supported by Hunan Provincial Key Research and Development Program,No.2021SK2002(to BW)the Natural Science Foundation of Hunan Province of China(General Program),No.2021JJ30938(to YL)。
文摘Degenerative cervical myelopathy is a common cause of spinal cord injury,with longer symptom duration and higher myelopathy severity indicating a worse prognosis.While numerous studies have investigated serological biomarkers for acute spinal cord injury,few studies have explored such biomarkers for diagnosing degenerative cervical myelopathy.This study involved 30 patients with degenerative cervical myelopathy(51.3±7.3 years old,12 women and 18 men),seven healthy controls(25.7±1.7 years old,one woman and six men),and nine patients with cervical spondylotic radiculopathy(51.9±8.6 years old,three women and six men).Analysis of blood samples from the three groups showed clear differences in transcriptomic characteristics.Enrichment analysis identified 128 differentially expressed genes that were enriched in patients with neurological disabilities.Using least absolute shrinkage and selection operator analysis,we constructed a five-gene model(TBCD,TPM2,PNKD,EIF4G2,and AP5Z1)to diagnose degenerative cervical myelopathy with an accuracy of 93.5%.One-gene models(TCAP and SDHA)identified mild and severe degenerative cervical myelopathy with accuracies of 83.3%and 76.7%,respectively.Signatures of two immune cell types(memory B cells and memory-activated CD4^(+)T cells)predicted levels of lesions in degenerative cervical myelopathy with 80%accuracy.Our results suggest that peripheral blood RNA biomarkers could be used to predict lesion severity in degenerative cervical myelopathy.
文摘Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing up.These normal experiences are potentially magnified for teenagers living with chronic illness or disability and their families.Advances in care have improved survival for children with a variety of serious chronic medical conditions such that many who may once have died in childhood now survive well into adulthood with ongoing morbidity.For those with highly complex needs,care is often provided at major paediatric hospitals with expertise,specially trained personnel,and resources to support young people and their families for the first decades of life.At the end of adolescence,however,it is generally appropriate and necessary for young adults and their caregivers to transition to the care of clinicians trained in the care of adults at general hospitals.While there are some well-managed models to support this journey of transition,these are often specific to certain conditions and usually do not involve intensive care.Many patients may encounter considerable challenges during this period.Difficulties may include the loss of established therapeutic relationships,a perception of austerity and reduced amenity in facilities oriented to caring for adult patients,and care by clinicians with less experience with more common paediatric conditions.In addition,there is a risk of potential conflict between clinicians and families regarding goals of care in the event of a critical illness when it occurs in a young adult with major disability and long-term health issues.These challenges present genuine opportunities to better understand the transition from paediatric to adult-based care and to improve processes that assist clinicians who support patients and families as they shift between healthcare settings.
文摘In 1993,the World Bank released a global report on the efficacy of health promotion,introducing the disability-adjusted life years(DALY)as a novel indicator.The DALY,a composite metric incorporating temporal and qualitative data,is grounded in preferences regarding disability status.This review delineates the algorithm used to calculate the value of the proposed DALY synthetic indicator and elucidates key methodological challenges associated with its application.In contrast to the quality-adjusted life years approach,derived from multi-attribute utility theory,the DALY stands as an independent synthetic indicator that adopts the assumptions of the Time Trade Off utility technique to define Disability Weights.Claiming to rely on no mathematical or economic theory,DALY users appear to have exempted themselves from verifying whether this indicator meets the classical properties required of all indicators,notably content validity,reliability,specificity,and sensitivity.The DALY concept emerged primarily to facilitate comparisons of the health impacts of various diseases globally within the framework of the Global Burden of Disease initiative,leading to numerous publications in international literature.Despite widespread adoption,the DALY synthetic indicator has prompted significant methodological concerns since its inception,manifesting in inconsistent and non-reproducible results.Given the substantial diffusion of the DALY indicator and its critical role in health impact assessments,a reassessment is warranted.This reconsideration is imperative for enhancing the robustness and reliability of public health decisionmaking processes.
文摘Photos of a 31‑year‑old man carrying his mother on his back at Tiananmen Square went viral on Chinese social media,drawing the praise of millions around the country,but Xiao Ma has been carrying his disabled mother for years and documenting their travels through short videos.
文摘Burden of disease research plays a pivotal role in global and national health policy by quantifying the impact of illnesses, injuries, and risk factors on populations. Through metrics such as disabilityadjusted life years (DALYs), years of life lost (YLLs),and years lived with disability (YLDs), it provides a comprehensive assessment of health loss, enabling evidence-based decision-making[1].
文摘BACKGROUND The occurrence of chronic pain and disability after acute orthopedic trauma is significantly correlated with psychological factors,particularly depression and anxiety.As such,assessment of these factors is crucial for postoperative rehabilitation.AIM To investigate the correlation between chronic pain,disability,and psychological factors(depression and anxiety)after acute orthopedic trauma surgery.METHODS Data from 120 patients,who underwent surgery for acute orthopedic trauma at Xi’an Traditional Chinese Medicine Hospital(Shaanxi Province,China)between June 2022 and June 2024,were retrospectively analyzed.Basic information and postoperative pain metrics[visual analog scale(VAS)],disability rating index(DRI),Hamilton anxiety rating scale(HAMA)and Hamilton depression rating scale(HAMD)were collected from electronic medical records.Pearson’s correlation analysis was used to examine associations between chronic pain VAS,DRI,HAMD,and HAMA scores.RESULTS Among the 120 patients[79(65.8%)males and 41(34.2%)females],postoperative VAS scores were significantly associated with HAMD and HAMA scores,with correlation coefficients of 0.625(P=0.027)and 0.568(P<0.001),respectively.Postoperative DRI scores were also significantly associated with HAMD and HAMA scores,with correlation coefficients of 0.683 and 0.557,respectively(both P<0.001).CONCLUSION Chronic pain and disability after surgery for acute orthopedic trauma are significantly correlated with psychological factors(depression and anxiety).Multidisciplinary teams should integrate mental health services to improve patient outcomes.
文摘Introduction: Stroke may have a negative impact on mental health and behavior. Cognitive disorders are common after stroke. They are rarely assessed in current clinical practice, particularly in our context. They constitute a real “invisible” handicap. In sub-Saharan Africa, we are not aware of any studies specifically assessing executive functions. These functions are at the heart of all adaptation processes to new or complex situations. This prompted the authors to carry out this study at the Ibrahima Pierre Ndiaye Neuroscience Department of the Fann National University Hospital Centre (Senegal). Objective and Methodology: The aim of this study was to assess and characterize post-stroke alterations in executive functions in our context. We conducted a descriptive cross-sectional study. It took place over a 4-month period from April 1 to August 31, 2021. Patients were matched to controls according to age, gender and educational level. Executive functions were assessed using the Frontal Assessment Battery (FAB). Results: A total of 30 patients with stroke were enrolled. These patients were matched to controls. The mean age of the patients was 46.87 ± 17.65 years. For the control group, it was 39.27 ± 12.33 years. The prevalence of executive function disorders was 20% in post-stroke patients. The majority of executive functions assessed were impaired. Sensitivity to interference and environmental autonomy were the only ones preserved. Conclusion: Impaired executive functions are common after stroke. They should be systematically assessed in all stroke patients to ensure optimal management.
基金Supported by the Natural Science Foundation Project of the Science and Technology Bureau of Yuzhong District,Chongqing,No.20240129.
文摘Total hip arthroplasty(THA)effectively treats advanced hip disorders,yet outcomes vary among patients.Frailty has become a crucial factor influencing these results.Several studies explored multiple preoperative factors affecting THA outcomes,highlighting the significance of age,Western Ontario and Mc-Master Universities Osteoarthritis Index,Center for Epidemiologic Studies Depression Scale,and central sensitization index scores in predicting post-operative recovery,emphasizing comprehensive preoperative assessments.Subsequent research has shown that frailty,measured by tools like the hospital frailty risk score and frailty deficit index,is significantly associated with adverse outcomes such as higher 30-day readmission rates,longer hospital stays,increased costs,and elevated mortality and complication risks in both primary and revision THA.Additionally,frailty related to short-term adverse events but stressed the need for standardized frailty measurement.Currently,there is no unified standard for assessing frailty before THA,which hinders cross-study comparison and evidence-based guideline development.Future research should focus on establishing a universal frailty assessment standard considering physical function,comorbidities,cognitive and psychological status.Prospective studies are also needed to clarify the causal relationship between frailty and long-term THA outcomes and identify modifiable factors for preoperative interventions.Overall,understanding the impact of frailty on THA outcomes is essential for improving patient care and resource utilization,especially in an aging population with a rising prevalence of hip disorders.
文摘Since the 1970s,a series of international and national sources have supported the principle of accessibility,which slowly has become a statuary norm and a legislative obligation.Each country has implemented accessibility through a singular policy.But in addition to the accessibility of a place or an activity,to inform about what is accessible is very important as well,and has not really taken off.Indeed,for disabled people,the difficulty lies not only with access to places and the use of resources,but also with the visibility of these resources.This means that information concerning accessibility has to be disclosed and provided effectively to disabled people,those involved with them and the relevant institutions.In different countries all over the world,many labels and pictograms have been created for this purpose and give information relating to accessibility.Using a socio-historical approach,we will present and analyze the different types of icons,symbols,pictograms and labels that have been put in place around the world and in France:what are they used for and for whom are they made?We will show that they are pointers which firstly reflect the diversity and range within the target group concerned by accessibility,and secondly the evolution of accessibility as a dynamic and ecological principle.
