Objective This study aimed to investigate the impact of glycemic control and diabetes duration on subsequent myocardial infarction(MI)in patients with both coronary heart disease(CHD)and type 2 diabetes(T2D).Methods W...Objective This study aimed to investigate the impact of glycemic control and diabetes duration on subsequent myocardial infarction(MI)in patients with both coronary heart disease(CHD)and type 2 diabetes(T2D).Methods We conducted a retrospective cohort study of 33,238 patients with both CHD and T2D in Shenzhen,China.Patients were categorized into 6 groups based on baseline fasting plasma glucose(FPG)levels and diabetes duration(from the date of diabetes diagnosis to the baseline date)to examine their combined effects on subsequent MI.Cox proportional hazards regression models were used,with further stratification by age,sex,and comorbidities to assess potential interactions.Results Over a median follow-up of 2.4 years,2,110 patients experienced MI.Compared to those with optimal glycemic control(FPG<6.1 mmol/L)and shorter diabetes duration(<10 years),the fullyadjusted hazard ratio(HR)(95%Confidence Interval[95%CI])for those with a diabetes duration of≥10 years and FPG>8.0 mmol/L was 1.93(95%CI:1.59,2.36).The combined effects of FPG and diabetes duration on MI were largely similar across different age,sex,and comorbidity groups,although the excess risk of MI associated with long-term diabetes appeared to be more pronounced among those with atrial fibrillation.Conclusion Our study indicates that glycemic control and diabetes duration significant influence the subsequent occurrence of MI in patients with both CHD and T2D.Tailored management strategies emphasizing strict glycemic control may be particularly beneficial for patients with longer diabetes duration and atrial fibrillation.展开更多
BACKGROUND Decreased renal function is a well-known risk factor for cardiovascular diseases(CVD)and death.However,the impact of diabetes duration and the glomerular filtration rate(GFR)on cardiovascular complications ...BACKGROUND Decreased renal function is a well-known risk factor for cardiovascular diseases(CVD)and death.However,the impact of diabetes duration and the glomerular filtration rate(GFR)on cardiovascular complications in patients with type 2 dia-betes has not been well studied.AIM To investigate the complex impact of longer diabetes duration and GFR on CVD and mortality.METHODS Subjects with diabetes age≥20 years,who underwent health check-ups from 2015 to 2016 were identified in the Korean National Health Insurance Service database.Based on diabetes duration,subjects were grouped into new-onset,<5 years,5–9 years,or≥10 years.The new-onset diabetes group[estimated GFR(eGFR):≥90 mL/min/1.73 m2]was the reference group.A Cox proportional hazards model adjusted for potential confounders was used to estimate the risk for myocardial infarction(MI),ischemic stroke(IS),and mortality.RESULTS During a 3.9-year follow-up of 2105228 patients,36003(1.7%)MIs,46496(2.2%)ISs,and 73549(3.5%)deaths were documented.Both longer diabetes duration and lower eGFR were independently associated with higher risks of MI,IS,and mortality,which were further amplified when these factors coexisted.Even patients with new-onset diabetes had elevated MI and IS risk at mildly reduced eGFR(60–90 mL/min/1.73 m^(2)).Mortality risk rose appreciably once eGFR declined below 60 mL/min/1.73 m^(2),particularly in those with longer diabetes duration.eGFR≥90 mL/min/1.73 m2 subgroups had higher death risk than eGFR 60–90 mL/min/1.73 m2 subgroups regardless of diabetic duration.CONCLUSION Increasing diabetes duration and decreasing eGFR are associated with increased risk of MI,IS,and mortality.For cardiovascular risk estimation,diabetes duration should be considered an important risk factor.展开更多
Avian incubation is characterised by the contact between the eggs and the bird's skin to transfer heat to increase egg temperature above ambient conditions. Birds can be attentive to the clutch all of the time or,...Avian incubation is characterised by the contact between the eggs and the bird's skin to transfer heat to increase egg temperature above ambient conditions. Birds can be attentive to the clutch all of the time or, particularly if only one parent incubates, attentiveness may be quite low. Attentiveness is related to egg size with large eggs having high attentiveness, whereas small eggs (<10 g) can have attentiveness ranging from 50% to 100%. Previous studies have suggested that incubation duration is a function of attentiveness albeit for small birds. This study tested the hypothesis that, after controlling for egg size and phylogeny, incubation duration would be a function of attentiveness. Data for 444 bird species representing 24 orders were analysed. Whilst egg mass had a significant relationship with incubation duration, there was no relationship with attentiveness for all of the species or a subset of the passerines. Despite egg temperature drops during an incubation recess, average day-time and night-time temperatures are similar in a range of species. Re-examination of previously reported temperature profiles recorded by dummy eggs over a 24-h period shows that after an incubation recess there seems to be an additional heat flux that raises egg temperature above that seen during night-time periods of constant incubation. The reasons why eggs under intermittent incubation are not considerably cooler than eggs during constant incubation are discussed.展开更多
BACKGROUND Sleep disorders are common health problems in the elderly.The effect of social isolation on sleep duration and sleep quality remains unclear in the Chinese community-dwelling elderly.AIM To explore the asso...BACKGROUND Sleep disorders are common health problems in the elderly.The effect of social isolation on sleep duration and sleep quality remains unclear in the Chinese community-dwelling elderly.AIM To explore the associations of social isolation with sleep duration and sleep quality in community-dwelling elderly people.METHODS A total of 7762 community-dwelling elderly people aged 60 years and older in Ningbo were recruited from June 2022 to August 2022.Data were collected using a questionnaire.Multivariate logistic regression was used to analyze the associations of social isolation with sleep duration and sleep quality.The KHB mediating effect model was used to test the mediating effect of depression and anxiety on these associations.RESULTS Among the participants,2656(34.2%)had abnormal sleep duration(<6 hours or>8 hours),1115(14.4%)had poor sleep quality,and 917(11.8%)had social isolation.After adjusting for confounding factors,compared with the elderly without social isolation,the odds ratios(95%CI)of abnormal sleep duration and poor sleep quality in the elderly with social isolation were 1.49(1.29-1.73)and 1.32(1.09-1.59),respectively.Depression partially mediated the associations of social isolation with sleep duration and sleep quality,accounting for 5.68%and 9.87%of the mediating effect,respectively.CONCLUSION Social isolation was found to be associated with sleep duration and sleep quality in community-dwelling elderly people.More attention should be paid to social isolation in the elderly.展开更多
This paper investigates the selective maintenance o systems that perform multi-mission in succession. Selective maintenance is performed on systems with limited break time to improve the success of the next mission. I...This paper investigates the selective maintenance o systems that perform multi-mission in succession. Selective maintenance is performed on systems with limited break time to improve the success of the next mission. In general, the duration of the mission is stochastic. However, existing studies rarely take into account system availability and the repairpersons with different skill levels. To solve this problem, a new multi-mission selective maintenance and repairpersons assignment model with stochastic duration of the mission are developed. To maximize the minimum phase-mission reliability while meeting the minimum system availability, the model is transformed into an optimization problem subject to limited maintenance resources. The optimization is then realized using an analytical method based on a self-programming function and a Monte Carlo simulation method, respectively. Finally, the validity of the model and solution method approaches are verified by numerical arithmetic examples. Comparative and sensitivity analyses are made to provide proven recommendations for decision-makers.展开更多
Objective:Immune checkpoint inhibitors(ICIs)have demonstrated substantial efficacy in patients with advanced non-small cell lung cancer(NSCLC).However,the optimal duration of ICI therapy remains unclear,and limited re...Objective:Immune checkpoint inhibitors(ICIs)have demonstrated substantial efficacy in patients with advanced non-small cell lung cancer(NSCLC).However,the optimal duration of ICI therapy remains unclear,and limited real-world data are available.The aim of this study was to evaluate the relationship between ICI therapy duration and overall survival(OS)in patients who achieved varying best overall response(BOR)during ICI treatment,and to compare patients treated for 6 to 18 months vs.at least 18 months.Methods:This retrospective cohort study included adult patients diagnosed with advanced NSCLC who received ICI therapy at the Zhejiang Cancer Hospital between 2017 and 2022.Data collection ended on May 1,2024,and statistical analysis was performed between May and June 2024.Results:Using strict entry criteria,we screened 487 patients with advanced NSCLC and identified 134 eligible patients.Among these patients,the median durations of immunotherapy and follow-up were 24.57 months and 43.60 months,respectively.The objective response rate(ORR)was 58.2%,and the median progression-free survival(PFS)was 10.6 months.Median OS was not reached.At the last follow-up,54 patients had no disease progression,and 118 patients remained alive.Patients treated with ICI therapy for≥18 months had superior survival to those treated for 6 to 18 months(P=0.039).Further analysis revealed that the survival benefit was associated with BOR during ICI therapy.Specifically,patients achieving complete response/partial response(CR/PR)who received≥18 months of ICI therapy had a trend toward longer median OS than those treated for 6 to 18 months,but the difference did not reach statistical significance(P=0.177).Patients with stable disease(SD)who received≥18 months of ICI therapy had a statistically longer median OS than those treated for 6 to 18 months(P=0.019).Among patients treated with ICIs for≥18 months,24 continued with ICI-based therapy and achieved a median PFS2 of 6.67 months,an ORR of 33.3%,and a disease control rate(DCR)of 83.3%.Conclusions:This study provides real-world evidence and novel insights into the need for continuing ICI therapy beyond 18 months in patients with advanced NSCLC who do not exhibit progressive disease.For patients achieving SD during ICI therapy,a treatment duration of at least 18 months appears appropriate.For patients achieving CR/PR,treatment decisions should be individualized according to patient-specific circumstances.However,owing to the retrospective study design,potential selection bias and confounding factors might have influenced the results.Therefore,our findings require further validation in prospective clinical studies.展开更多
Type 2 diabetes(T2D)is a global public health issue.In 2021,537 million adults were diagnosed with T2D,corresponding to 10.5%of adults aged 20 and older.^(1)T2D increases the risks for morbidity,disability,and prematu...Type 2 diabetes(T2D)is a global public health issue.In 2021,537 million adults were diagnosed with T2D,corresponding to 10.5%of adults aged 20 and older.^(1)T2D increases the risks for morbidity,disability,and premature mortality,which increased by 3%between 2000 and 2019.2 Evidence is strong that maintaining a healthy diet,engaging in regular physical activity(PA),and preventing obesity can prevent or delay the incidence of T2D.展开更多
The duration of the extratropical transition(ET)of tropical cyclones(TCs)is often closely associated with disaster intensity.Therefore,it is essential to understand the key factors that influence ET duration.Using the...The duration of the extratropical transition(ET)of tropical cyclones(TCs)is often closely associated with disaster intensity.Therefore,it is essential to understand the key factors that influence ET duration.Using the TC best-track data and reanalysis data,this study investigates the structural characteristics and key influencing factors of ET duration in the western North Pacific(WNP)during 1981–2022.Results show that,compared to TCs that undergo ET rapidly(≤12 h),TCs that experience ET slowly(≥24 h)undergo a more prolonged and complex ET process,maintaining a warm core and an upright structure for extended periods.By contrast,TCs undergoing rapid transition experience structural disintegration within 6–12 h after ET onset.Further analysis reveals that TCs with longer ET durations are characterized by stronger warm cores,more abundant moisture,weaker environmental vertical wind shear,slower translation speeds,and a longer residence time over warmer sea surface temperatures(SSTs),all of which support the maintenance of axisymmetric structures with strong warm cores.Environmental and structural factors,including cold-air intensity,vertical wind shear,TC translation speed,SST,relative humidity,TC intensity,the radius of 17 m s^(-1)wind,mean sea level pressure,and the radius of maximum wind,are found to exist significant correlation with ET duration.Cold-air intensity exhibited the highest correlation(r=–0.35),followed by TC translation speed and SST.A relative importance analysis shows that the environmental factors play a more substantial role than the internal TC structure,accounting for about 19.23%of the variance,with TC translation speed and cold-air effects explaining 11.68%.Based on the nine factors,a statistical forecasting model was developed,which shows considerable skill in predicting ET duration.展开更多
BACKGROUND Neuroendocrine dysfunction,especially involving the hypothalamic-pituitarythyroid axis,plays a critical role in the onset and progression of schizophrenia.Alterations in thyroid stimulating hormone(TSH),tri...BACKGROUND Neuroendocrine dysfunction,especially involving the hypothalamic-pituitarythyroid axis,plays a critical role in the onset and progression of schizophrenia.Alterations in thyroid stimulating hormone(TSH),triiodothyronine(T3),free T3(FT3),thyroxine(T4),and free T4 have been implicated in this process.Although previous studies have established an association between thyroid function and psychiatric symptoms,how thyroid hormone levels vary with disease duration remains underexplored.AIM To investigate duration stage-specific associations between thyroid hormones and psychotic symptoms among inpatients with stable schizophrenia.METHODS This cross-sectional study was conducted at Zigong Mental Health Center,China,and included 237 hospitalized patients with stable schizophrenia.Participants were stratified into three groups based on disease duration:0-10 years,10.1-20 years,and over 20 years.Peripheral blood samples were collected to measure serum thyroid hormone levels.Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale.Covariate-adjusted linear regression analyses were performed to assess the relationships between thyroid hormone levels and Positive and Negative Syndrome Scale sub-scale scores.RESULTS The relationship between thyroid hormones and psychotic symptoms varied by disease duration.In patients with a disease course of 0-10 years,T4[β=-0.848;95%confidence interval(CI):-1.564 to-0.133;P=0.021]and FT3(β=-2.483;95%CI:-4.693 to-0.273;P=0.028)levels were significantly inversely associated with general psychopathology scores.Among those with 10.1-20 years of disease,only TSH showed a significant negative correlation with general psychopathology(β=-1.429;95%CI:-2.348 to-0.509;P=0.003).No significant correlations were found in the>20 years group.CONCLUSION The associations between thyroid hormones and psychotic symptoms vary according to the duration of schizophrenia(T4/FT3 early;TSH mid),enabling the development of stage-adapted models and management.展开更多
Exotic plant invasions and increased atmospheric carbon dioxide(CO_(2))concentration have been determined to independently affect soil nematodes,a key component of soil biota.However,little is known about the long-ter...Exotic plant invasions and increased atmospheric carbon dioxide(CO_(2))concentration have been determined to independently affect soil nematodes,a key component of soil biota.However,little is known about the long-term effects of these two global change factors and their interactive effects.Over three consecutive years,we cultivated invasive alien plant Xanthium strumarium and its two phylogenetically related natives under both ambient(aCO_(2))and elevated(eCO_(2))atmospheric CO_(2)concentrations,and determined the effects of the invader and natives on soil nematodes under different CO_(2)concentrations and the relevant mechanism.The abundance of total soil nematodes and that of the dominant trophic group(herbivores)were significantly affected by plant species and CO_(2)concentration,and these effects were dependent on the experimental duration,however,the Shannon-diversity of nematodes was not affected by these factors.Under aCO_(2),both invasive and native species significantly increased the total nematode abundance and that of the dominant trophic group with increasing experimental duration,and the amplitude of the increase was greater under the invader relative to the natives.The eCO_(2)increased total nematode abundance(second year)and that of the dominant trophic group(third year)under the invader,but not under the natives(or even decreased)with increasing experimental duration.Root litter had greater effects on soil nematode abundance than leaf litter and root exudates did.This study indicates that eCO_(2)would aggravate effects of invasive plants on soil nematodes by increasing abundance,and these effects would vary with the duration.展开更多
The associations of volatile organic compounds(VOCs)exposure with short sleep duration(SSD)have rarely been studied.We aimed to evaluate the correlation between VOC exposure and SSD risk,while also exploring the poten...The associations of volatile organic compounds(VOCs)exposure with short sleep duration(SSD)have rarely been studied.We aimed to evaluate the correlation between VOC exposure and SSD risk,while also exploring the potential mediating influence of depressive symptoms.Blood concentrations of seven VOCs,namely benzene,toluene,ethylbenzene,m-/p-xylene,o-xylene,styrene(collectively known as BTEXS),and 1,4-dichlorobenzene,were analyzed in 2905 U.S.adults.Weighted logistic regression,quantile-based g-computation(QGC),and weighted quantile sum(WQS)regression were employed to investigate associations between selected VOCs and SSD risk.Mediation analyses were conducted to explore the potential mediating effects of depressive symptoms on these relationships.Increased blood levels of BTEXS were positively correlated with SSD risk,with odds ratios(OR)ranging from 1.130 to 1.212(all P<0.05).A nonlinear association between toluene concentration and SSD risk was observed(P for nonlinearity=0.028).Both QGC and WQS analyses indicated a positive association between co-exposure to VOCs and SSD,with styrene showing the highest positive weights(QGC:OR=1.313,95%confidence interval(CI):1.038–1.660;WQS:OR=1.386,95%CI:1.111–1.731).Furthermore,BTEXS exposure was positively linked to depressive symptoms,which in turn were significantly associated with SSD risk.Mediation analyses revealed that depressive symptoms partially mediated the relationships between individual and mixed VOCs and SSD risk,with mediation proportions ranging from 15.87%to 20.54%(all P<0.05).These findings indicated that exposure to VOCs increased SSD risk,with depressive symptoms playing a partial mediating role.展开更多
Background It remains unclear whether sleep duration and physical activity(PA)trajectories in middle-aged and older adults are associated with different risks of cardiovascular diseases(CVDs).This study aimed to explo...Background It remains unclear whether sleep duration and physical activity(PA)trajectories in middle-aged and older adults are associated with different risks of cardiovascular diseases(CVDs).This study aimed to explore the trajectories of total sleep duration and PA among middle-aged and older Chinese adults and their impact on CVD risk.Methods This study was based on the China Health and Retirement Longitudinal Study.12009 adults aged 45 years and older from five waves were included.CVD events were measured by self-reports of heart disease and stroke.We first used groupbased trajectory modeling to identify total sleep duration and PA trajectories from 2011 to 2020,and then employed logistic regression models to analyze their risk for CVD.Results We identified three sleep duration and PA trajectories.The risk of heart disease increased by 33%(OR=1.31,95%CI:1.12-1.53)for the short sleep duration trajectory(vs.moderate sleep duration trajectory),by 40%(OR=1.40,95%CI:1.06-1.84)for the high decreasing PA trajectory,and by 20%(OR=1.20,95%CI:1.01-1.42)for the low stable PA trajectory(vs.high stable PA trajectory),respectively.Similar results for stroke and CVD as the outcomes were also observed,but the higher risk of stroke in the high decreasing PA trajectory group was not statistically significant.The joint effects of sleep and PA showed lower risks of heart disease and stroke in trajectories with moderate or long sleep duration and high stable PA compared with short sleep duration and a low stable PA trajectory.Conclusions Short total sleep duration,high decreasing PA,and low stable PA trajectories could increase the risk of CVDs among middle-aged and older adults.Long-term moderate to long total sleep durations and high stable PA trajectories might be optimal for preventing CVDs.展开更多
Geomagnetic substorms release plasma and energy from the magnetotail to the inner magnetosphere and high latitude ionosphere.In this study,we investigate substorms of different time duration,observed during the years ...Geomagnetic substorms release plasma and energy from the magnetotail to the inner magnetosphere and high latitude ionosphere.In this study,we investigate substorms of different time duration,observed during the years 1982 to 2012.We measure substorm duration by a method based on the SME index.Our results demonstrate that longer-duration substorms occur more frequently during solar maximum years,and more frequently between the months of May and July,likely due to the higher polar ionospheric conductivity and more sunward geomagnetic pole directions during summer in the northern hemisphere.Additionally,longer substorms occur more frequently under stronger,longer-lasting southward IMF,and are accompanied by slower solar winds,suggesting that extended magnetic reconnection is required to drive longer substorms.Substorm durations are not significantly related to the minimum SML index,but longer substorms usually have higher SMU and continuously rising PC indices.The SME indices of long-duration substorms show a bimodal MLT distribution located near midnight and dusk after substorm onset,with the peak originally at midnight moving eastward to the morning side during the late recovery phase.Longer duration substorms have a stronger effect on the overall ring current at all MLT sectors except dawnside.Our results provide new insights into the development process and influencing factors of substorms,from the expansion phase to the recovery phase.展开更多
Purpose:The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity(PA)with the risk of incident type 2 diabetes in a populat...Purpose:The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity(PA)with the risk of incident type 2 diabetes in a population-based prospective cohort study.Methods:Altogether,88,000 participants(mean age=62.2±7.9 years,mean±SD)were included from the UK Biobank.Sleep duration(short:<6 h/day;normal:6-8 h/day;long:>8 h/day)and PA of different intensities were measured using a wrist-won accelerometer over a 7-day period between 2013 and 2015.PA was classified according to the median or World Health Organization-recommendation:total volume of PA(high,low),moderate-to-vigorous PA(MVPA)(recommended,not recommended),and light-intensity PA(high,low).Incidence of type 2diabetes was ascertained using hospital records or death registries.Results:During a median follow-up of 7.0 years,1615 incident type 2 diabetes cases were documented.Compared with normal sleep duration,short(hazard ratio(HR)=1.21,95%confidence interval(95%CI):1.03-1.41)but not long sleep duration(HR=1.01,95%CI:0.89-1.15)was associated with excessive type 2 diabetes risk.This increased risk among short sleepers seems to be protected against by PA.Compared with normal sleepers with high or recommended PA,short sleepers with low volume of PA(HR=1.81,95%CI:1.46-2.25),not recommended(below the World Health Organization-recommended level of)MVPA(HR=1.92,95%CI:1.55-2.36),or low light-intensity PA(HR=1.49,95%CI:1.13-1.90)had a higher risk of type 2 diabetes,while short sleepers with a high volume of PA(HR=1.14,95%CI:0.88-1.49),recommended MVPA(HR=1.02,95%CI:0.71-1.48),or high light-intensity PA(HR=1.14,95%CI:0.92-1.41)did not.Conclusion:Accelerometer-measured short but not long sleep duration was associated with a higher risk of incident type 2 diabetes.A higher level of PA,regardless of intensity,potentially ameliorates this excessive risk.展开更多
The surface solar radiation in most parts of the world has undergone a phenomenon known as global dimming and brightening,characterized by an initial decrease followed by an increase.As a result,the sunshine duration(...The surface solar radiation in most parts of the world has undergone a phenomenon known as global dimming and brightening,characterized by an initial decrease followed by an increase.As a result,the sunshine duration(SD)has decreased in the past 60 years.Against the backdrop of global dimming and brightening,SD has decreased to varying degrees in many regions of China.Using the observed data of SD,cloud amount(total cloud amount and low cloud amount,abbreviated as TCA and LCA),precipitation,and relative humidity(RH)from 34 meteorological stations in Chongqing during the period of 1961-2020,along with a digital elevation model(DEM)with a resolution of 90 m,this study analyzed the spatiotemporal variations and influencing factors of SD.The analysis employed methods such as linear regression,Mann-Kendall test,wavelet transformation,and DEM-based possible SD distributed model.The results showed that the annual SD in Chongqing has significantly decreased over the last 60 years,with a decreasing interannual trend rate(ITR)of 40.4 h/10a.Except for no obvious trend in spring,SD decreased significantly in summer,autumn and winter at the ITR of 21.1 h/10a,8.5 h/10a and 7.5 h/10a,respectively.An abrupt decrease in the annual SD was found in 1979.The difference before and after the abrupt decrease was 177.7 h.The difference before and after the abrupt decrease was 177.7 h.The annual SD possessed the oscillation period of 11a.The spatial heterogeneity of the mean annual SD during the last 60 years was obvious.The distribution of SD in Chongqing is high in the northeast and low in the southeast.In addition,about 73%of the total area in Chongqing showed a significant and very significant decreasing trend.The regions with significant changes are mainly concentrated in the regions with altitudes of 200~1000 m.The increasing LCA was the main cause of the decrease of the annual SD in the regions with 200-400 m altitude decreased the most and changed the most.Increasing LCA is the primary cause of the reduction in annual SD,showing a strong negative correlation coefficient of-0.7292.In Chongqing,PM2.5 concentration showed a significant decrease trend in annual,spring,autumn and winter during 2000-2020,but the significant correlation between PM2.5 concentration and SD was only in autumn and reached an extremely significant level.展开更多
Objective:To explore the best duration of moxibustion on lumbar disk herniation(LDH).Methods:A total of 88 patients were randomly divided into control group and 15-min,30-min,and 45-min moxibustion groups.The control ...Objective:To explore the best duration of moxibustion on lumbar disk herniation(LDH).Methods:A total of 88 patients were randomly divided into control group and 15-min,30-min,and 45-min moxibustion groups.The control group was treated with conventional therapy,while the other 3 groups were intervened with different moxibustion durations.Low back pain,dysfunction,lumbar function,and effective rates were evaluated before,in the first week and second week of intervention.Results:In low back pain,compared with the control group,the score of the 15-min group had no significant difference,but it was significantly lower in the 30-min and 45-min groups.In dysfunction and lumbar function,compared with the control group,the scores of the 15-min,30-min,and 45-min groups were significantly higher,and the scores of the 30-min and 45-min groups were significantly higher,but there was no significant difference between the 30-min and 45-min group.In effective rates,there was no significant difference between the control group and 15-min group;the effective rates of the 30-min and 45-min groups were significantly higher than those of the control group.Conclusions:Moxibustion has good therapeutic effect on LDH with specific moxibustion time.展开更多
Coastal management in China is confronted with an urgent choice between natural restoration and maintenance of existing seawalls and reclaimed land for economic development.A key criterion for making this decision is ...Coastal management in China is confronted with an urgent choice between natural restoration and maintenance of existing seawalls and reclaimed land for economic development.A key criterion for making this decision is the resilience to coastal flooding,which depends on the ability to predict tidal level.Tidal duration asymmetry(TDA)is a key parameter in determination of the arrival and duration of flood tides.This study selected the western inner shelf of the Yellow Sea(WYS)as the study area and investigated the responses of TDA to different shoreline configurations and relative sea level rise.The responses of TDA to shoreline reconstruction yielded spatial variability locally and remotely.In the nearshore area,the responses of TDA to the complex ocean environment mainly originated from the combined functions of reflection,bottom friction,and advection,which controlled the energy transfer from M2 or S2 constituents to their overtides or compound tides.The sensitivity of TDA to coastline typologies was not limited to coastal waters but could stretch over the entire inner shelf.The vulnerability of tidal responses was due to the displacement of the M2 amphidrome of the Kelvin wave on the WYS,which in turn changed tidal energy fluxes over the regime.The relative sea level rise could intensify the feedback of TDA to seawalls and land reclamation.展开更多
Today,urban traffic,growing populations,and dense transportation networks are contributing to an increase in traffic incidents.These incidents include traffic accidents,vehicle breakdowns,fires,and traffic disputes,re...Today,urban traffic,growing populations,and dense transportation networks are contributing to an increase in traffic incidents.These incidents include traffic accidents,vehicle breakdowns,fires,and traffic disputes,resulting in long waiting times,high carbon emissions,and other undesirable situations.It is vital to estimate incident response times quickly and accurately after traffic incidents occur for the success of incident-related planning and response activities.This study presents a model for forecasting the traffic incident duration of traffic events with high precision.The proposed model goes through a 4-stage process using various features to predict the duration of four different traffic events and presents a feature reduction approach to enable real-time data collection and prediction.In the first stage,the dataset consisting of 24,431 data points and 75 variables is prepared by data collection,merging,missing data processing and data cleaning.In the second stage,models such as Decision Trees(DT),K-Nearest Neighbour(KNN),Random Forest(RF)and Support Vector Machines(SVM)are used and hyperparameter optimisation is performed with GridSearchCV.In the third stage,feature selection and reduction are performed and real-time data are used.In the last stage,model performance with 14 variables is evaluated with metrics such as accuracy,precision,recall,F1-score,MCC,confusion matrix and SHAP.The RF model outperforms other models with an accuracy of 98.5%.The study’s prediction results demonstrate that the proposed dynamic prediction model can achieve a high level of success.展开更多
This letter discusses the publication by Feng et al.Iodine,selenium,and vitamin D are closely associated with thyroid hormone production in humans;however,the efficacy of selenium and vitamin D supplementation for typ...This letter discusses the publication by Feng et al.Iodine,selenium,and vitamin D are closely associated with thyroid hormone production in humans;however,the efficacy of selenium and vitamin D supplementation for type 2 diabetes mellitus(T2DM)patients with Hashimoto’s thyroiditis(HT)remains controversial.In the retrospective study we discuss herein,the authors highlighted significant improvements in thyroid function,thyroid antibodies,blood glucose,and blood lipid in T2DM patients with HT following addition of vitamin D and selenium to their antidiabetic regimens,underscoring the value of these supplements.Our team is currently engaged in research exploring the relationship between micronutrients and HT,and we have obtained invaluable insights from the aforementioned study.Based on this research and current literature,we recommend a regimen of 4000 IU/day of vitamin D and 100-200μg/day of selenium for over three months to six months for patients with HT,particularly for those with concurrent T2DM.展开更多
Neonates,especially admitted to neonatal intensive care unit,frequently need various medical interventions in their early days.A common procedure is the heel prick for blood sampling.Although necessary for diagnosis,t...Neonates,especially admitted to neonatal intensive care unit,frequently need various medical interventions in their early days.A common procedure is the heel prick for blood sampling.Although necessary for diagnosis,this procedure can be stressful for neonates,causing pain,extended crying,and discomfort.Reducing distress in neonates during such procedures is important for the well‐being of neonates and the satisfaction of caregivers and healthcare providers.Therefore,this review aims to identify and compare the efficacy of 25%dextrose and breast milk on pain and duration of cry among neonates during heel-lance.As part of its review process,the article examined widely used databases,including PubMed,EMBASE,Cochrane,Academia,and Google Scholar.For the meta-analysis,the authors utilized RevMan 5.4.All eligible trials were analyzed using the Cochrane Risk of Bias Tool to assess the quality of the included studies and evaluate the risk of bias.Out of 131 studies reviewed,seven studies were included in meta-analysis of pain,and four studies were included in duration of cry.The results show that 25%dextrose is more effective to reduce pain among neonates during minor invasive procedure like heel prick(P<0.00001),whereas both interventions are effective in the reduction of crying duration.This review highlights that dextrose is more effective in reducing pain in comparison to breast milk.However,additional well-designed studies with larger sample sizes and extended follow-up periods are needed to validate and build upon the current findings.Hence,this review underscores the importance of utilizing effective pain management strategies,such as 25%dextrose,to enhance neonatal care and improve the overall well-being of newborns during invasive procedures.展开更多
基金supported by the R&D project of Pazhou Lab(Huangpu)under Grant 2023K0610the National Natural Science Foundation of China(Grants 12126602)+4 种基金the National Natural Science Foundation of China(Grants 82030102)the Shenzhen Medical Research Fund(Grants C2302001)the Shenzhen Science and Technology Innovation Committee(No.ZDSYS20200810171403013)the Chinese Postdoctoral Science Foundation(No.2022M721463)the Ministry of Science and Technology of China(Grants 2022YFC3702703).
文摘Objective This study aimed to investigate the impact of glycemic control and diabetes duration on subsequent myocardial infarction(MI)in patients with both coronary heart disease(CHD)and type 2 diabetes(T2D).Methods We conducted a retrospective cohort study of 33,238 patients with both CHD and T2D in Shenzhen,China.Patients were categorized into 6 groups based on baseline fasting plasma glucose(FPG)levels and diabetes duration(from the date of diabetes diagnosis to the baseline date)to examine their combined effects on subsequent MI.Cox proportional hazards regression models were used,with further stratification by age,sex,and comorbidities to assess potential interactions.Results Over a median follow-up of 2.4 years,2,110 patients experienced MI.Compared to those with optimal glycemic control(FPG<6.1 mmol/L)and shorter diabetes duration(<10 years),the fullyadjusted hazard ratio(HR)(95%Confidence Interval[95%CI])for those with a diabetes duration of≥10 years and FPG>8.0 mmol/L was 1.93(95%CI:1.59,2.36).The combined effects of FPG and diabetes duration on MI were largely similar across different age,sex,and comorbidity groups,although the excess risk of MI associated with long-term diabetes appeared to be more pronounced among those with atrial fibrillation.Conclusion Our study indicates that glycemic control and diabetes duration significant influence the subsequent occurrence of MI in patients with both CHD and T2D.Tailored management strategies emphasizing strict glycemic control may be particularly beneficial for patients with longer diabetes duration and atrial fibrillation.
基金Supported by the National Research Foundation of Korea grant funded by the Korea government,No.RS-2023-00217317the Korea Health Technology R and D Project through the Korea Health Industry Development Institute funded by the Ministry of Health and Welfare,Republic of Korea,No.RS-2024-00439029.
文摘BACKGROUND Decreased renal function is a well-known risk factor for cardiovascular diseases(CVD)and death.However,the impact of diabetes duration and the glomerular filtration rate(GFR)on cardiovascular complications in patients with type 2 dia-betes has not been well studied.AIM To investigate the complex impact of longer diabetes duration and GFR on CVD and mortality.METHODS Subjects with diabetes age≥20 years,who underwent health check-ups from 2015 to 2016 were identified in the Korean National Health Insurance Service database.Based on diabetes duration,subjects were grouped into new-onset,<5 years,5–9 years,or≥10 years.The new-onset diabetes group[estimated GFR(eGFR):≥90 mL/min/1.73 m2]was the reference group.A Cox proportional hazards model adjusted for potential confounders was used to estimate the risk for myocardial infarction(MI),ischemic stroke(IS),and mortality.RESULTS During a 3.9-year follow-up of 2105228 patients,36003(1.7%)MIs,46496(2.2%)ISs,and 73549(3.5%)deaths were documented.Both longer diabetes duration and lower eGFR were independently associated with higher risks of MI,IS,and mortality,which were further amplified when these factors coexisted.Even patients with new-onset diabetes had elevated MI and IS risk at mildly reduced eGFR(60–90 mL/min/1.73 m^(2)).Mortality risk rose appreciably once eGFR declined below 60 mL/min/1.73 m^(2),particularly in those with longer diabetes duration.eGFR≥90 mL/min/1.73 m2 subgroups had higher death risk than eGFR 60–90 mL/min/1.73 m2 subgroups regardless of diabetic duration.CONCLUSION Increasing diabetes duration and decreasing eGFR are associated with increased risk of MI,IS,and mortality.For cardiovascular risk estimation,diabetes duration should be considered an important risk factor.
文摘Avian incubation is characterised by the contact between the eggs and the bird's skin to transfer heat to increase egg temperature above ambient conditions. Birds can be attentive to the clutch all of the time or, particularly if only one parent incubates, attentiveness may be quite low. Attentiveness is related to egg size with large eggs having high attentiveness, whereas small eggs (<10 g) can have attentiveness ranging from 50% to 100%. Previous studies have suggested that incubation duration is a function of attentiveness albeit for small birds. This study tested the hypothesis that, after controlling for egg size and phylogeny, incubation duration would be a function of attentiveness. Data for 444 bird species representing 24 orders were analysed. Whilst egg mass had a significant relationship with incubation duration, there was no relationship with attentiveness for all of the species or a subset of the passerines. Despite egg temperature drops during an incubation recess, average day-time and night-time temperatures are similar in a range of species. Re-examination of previously reported temperature profiles recorded by dummy eggs over a 24-h period shows that after an incubation recess there seems to be an additional heat flux that raises egg temperature above that seen during night-time periods of constant incubation. The reasons why eggs under intermittent incubation are not considerably cooler than eggs during constant incubation are discussed.
基金Supported by Ningbo Medical and Health Brand Discipline,No.PPXK2024-07and Ningbo Top Medical and Health Research Program,No.2022030410.
文摘BACKGROUND Sleep disorders are common health problems in the elderly.The effect of social isolation on sleep duration and sleep quality remains unclear in the Chinese community-dwelling elderly.AIM To explore the associations of social isolation with sleep duration and sleep quality in community-dwelling elderly people.METHODS A total of 7762 community-dwelling elderly people aged 60 years and older in Ningbo were recruited from June 2022 to August 2022.Data were collected using a questionnaire.Multivariate logistic regression was used to analyze the associations of social isolation with sleep duration and sleep quality.The KHB mediating effect model was used to test the mediating effect of depression and anxiety on these associations.RESULTS Among the participants,2656(34.2%)had abnormal sleep duration(<6 hours or>8 hours),1115(14.4%)had poor sleep quality,and 917(11.8%)had social isolation.After adjusting for confounding factors,compared with the elderly without social isolation,the odds ratios(95%CI)of abnormal sleep duration and poor sleep quality in the elderly with social isolation were 1.49(1.29-1.73)and 1.32(1.09-1.59),respectively.Depression partially mediated the associations of social isolation with sleep duration and sleep quality,accounting for 5.68%and 9.87%of the mediating effect,respectively.CONCLUSION Social isolation was found to be associated with sleep duration and sleep quality in community-dwelling elderly people.More attention should be paid to social isolation in the elderly.
文摘This paper investigates the selective maintenance o systems that perform multi-mission in succession. Selective maintenance is performed on systems with limited break time to improve the success of the next mission. In general, the duration of the mission is stochastic. However, existing studies rarely take into account system availability and the repairpersons with different skill levels. To solve this problem, a new multi-mission selective maintenance and repairpersons assignment model with stochastic duration of the mission are developed. To maximize the minimum phase-mission reliability while meeting the minimum system availability, the model is transformed into an optimization problem subject to limited maintenance resources. The optimization is then realized using an analytical method based on a self-programming function and a Monte Carlo simulation method, respectively. Finally, the validity of the model and solution method approaches are verified by numerical arithmetic examples. Comparative and sensitivity analyses are made to provide proven recommendations for decision-makers.
基金supported by the Natural Scientific Foundation of Zhejiang Province,China(Grant No.LTGY23H160007).
文摘Objective:Immune checkpoint inhibitors(ICIs)have demonstrated substantial efficacy in patients with advanced non-small cell lung cancer(NSCLC).However,the optimal duration of ICI therapy remains unclear,and limited real-world data are available.The aim of this study was to evaluate the relationship between ICI therapy duration and overall survival(OS)in patients who achieved varying best overall response(BOR)during ICI treatment,and to compare patients treated for 6 to 18 months vs.at least 18 months.Methods:This retrospective cohort study included adult patients diagnosed with advanced NSCLC who received ICI therapy at the Zhejiang Cancer Hospital between 2017 and 2022.Data collection ended on May 1,2024,and statistical analysis was performed between May and June 2024.Results:Using strict entry criteria,we screened 487 patients with advanced NSCLC and identified 134 eligible patients.Among these patients,the median durations of immunotherapy and follow-up were 24.57 months and 43.60 months,respectively.The objective response rate(ORR)was 58.2%,and the median progression-free survival(PFS)was 10.6 months.Median OS was not reached.At the last follow-up,54 patients had no disease progression,and 118 patients remained alive.Patients treated with ICI therapy for≥18 months had superior survival to those treated for 6 to 18 months(P=0.039).Further analysis revealed that the survival benefit was associated with BOR during ICI therapy.Specifically,patients achieving complete response/partial response(CR/PR)who received≥18 months of ICI therapy had a trend toward longer median OS than those treated for 6 to 18 months,but the difference did not reach statistical significance(P=0.177).Patients with stable disease(SD)who received≥18 months of ICI therapy had a statistically longer median OS than those treated for 6 to 18 months(P=0.019).Among patients treated with ICIs for≥18 months,24 continued with ICI-based therapy and achieved a median PFS2 of 6.67 months,an ORR of 33.3%,and a disease control rate(DCR)of 83.3%.Conclusions:This study provides real-world evidence and novel insights into the need for continuing ICI therapy beyond 18 months in patients with advanced NSCLC who do not exhibit progressive disease.For patients achieving SD during ICI therapy,a treatment duration of at least 18 months appears appropriate.For patients achieving CR/PR,treatment decisions should be individualized according to patient-specific circumstances.However,owing to the retrospective study design,potential selection bias and confounding factors might have influenced the results.Therefore,our findings require further validation in prospective clinical studies.
文摘Type 2 diabetes(T2D)is a global public health issue.In 2021,537 million adults were diagnosed with T2D,corresponding to 10.5%of adults aged 20 and older.^(1)T2D increases the risks for morbidity,disability,and premature mortality,which increased by 3%between 2000 and 2019.2 Evidence is strong that maintaining a healthy diet,engaging in regular physical activity(PA),and preventing obesity can prevent or delay the incidence of T2D.
基金National Key R&D Program of China(2022YFC3004200)Science and Technology Commission of Shanghai Municipality,China(23DZ1204703)。
文摘The duration of the extratropical transition(ET)of tropical cyclones(TCs)is often closely associated with disaster intensity.Therefore,it is essential to understand the key factors that influence ET duration.Using the TC best-track data and reanalysis data,this study investigates the structural characteristics and key influencing factors of ET duration in the western North Pacific(WNP)during 1981–2022.Results show that,compared to TCs that undergo ET rapidly(≤12 h),TCs that experience ET slowly(≥24 h)undergo a more prolonged and complex ET process,maintaining a warm core and an upright structure for extended periods.By contrast,TCs undergoing rapid transition experience structural disintegration within 6–12 h after ET onset.Further analysis reveals that TCs with longer ET durations are characterized by stronger warm cores,more abundant moisture,weaker environmental vertical wind shear,slower translation speeds,and a longer residence time over warmer sea surface temperatures(SSTs),all of which support the maintenance of axisymmetric structures with strong warm cores.Environmental and structural factors,including cold-air intensity,vertical wind shear,TC translation speed,SST,relative humidity,TC intensity,the radius of 17 m s^(-1)wind,mean sea level pressure,and the radius of maximum wind,are found to exist significant correlation with ET duration.Cold-air intensity exhibited the highest correlation(r=–0.35),followed by TC translation speed and SST.A relative importance analysis shows that the environmental factors play a more substantial role than the internal TC structure,accounting for about 19.23%of the variance,with TC translation speed and cold-air effects explaining 11.68%.Based on the nine factors,a statistical forecasting model was developed,which shows considerable skill in predicting ET duration.
基金Supported by the Zigong Key Science and Technology Plan(Collaborative Innovation Project of Zigong Institute of Brain Sciences),No.2023-NKY-02-04,No.2023-NKY-02-07,No.2023-NKY-03-03,and No.2024-NKY-02-07.
文摘BACKGROUND Neuroendocrine dysfunction,especially involving the hypothalamic-pituitarythyroid axis,plays a critical role in the onset and progression of schizophrenia.Alterations in thyroid stimulating hormone(TSH),triiodothyronine(T3),free T3(FT3),thyroxine(T4),and free T4 have been implicated in this process.Although previous studies have established an association between thyroid function and psychiatric symptoms,how thyroid hormone levels vary with disease duration remains underexplored.AIM To investigate duration stage-specific associations between thyroid hormones and psychotic symptoms among inpatients with stable schizophrenia.METHODS This cross-sectional study was conducted at Zigong Mental Health Center,China,and included 237 hospitalized patients with stable schizophrenia.Participants were stratified into three groups based on disease duration:0-10 years,10.1-20 years,and over 20 years.Peripheral blood samples were collected to measure serum thyroid hormone levels.Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale.Covariate-adjusted linear regression analyses were performed to assess the relationships between thyroid hormone levels and Positive and Negative Syndrome Scale sub-scale scores.RESULTS The relationship between thyroid hormones and psychotic symptoms varied by disease duration.In patients with a disease course of 0-10 years,T4[β=-0.848;95%confidence interval(CI):-1.564 to-0.133;P=0.021]and FT3(β=-2.483;95%CI:-4.693 to-0.273;P=0.028)levels were significantly inversely associated with general psychopathology scores.Among those with 10.1-20 years of disease,only TSH showed a significant negative correlation with general psychopathology(β=-1.429;95%CI:-2.348 to-0.509;P=0.003).No significant correlations were found in the>20 years group.CONCLUSION The associations between thyroid hormones and psychotic symptoms vary according to the duration of schizophrenia(T4/FT3 early;TSH mid),enabling the development of stage-adapted models and management.
基金supported by the National Key R&D Program of China(2023YFC2604500)the National Natural Science Foundation of China(32171662,32471753 and 32171666)the Natural Science Foundation of Liaoning(2020-MS-199).
文摘Exotic plant invasions and increased atmospheric carbon dioxide(CO_(2))concentration have been determined to independently affect soil nematodes,a key component of soil biota.However,little is known about the long-term effects of these two global change factors and their interactive effects.Over three consecutive years,we cultivated invasive alien plant Xanthium strumarium and its two phylogenetically related natives under both ambient(aCO_(2))and elevated(eCO_(2))atmospheric CO_(2)concentrations,and determined the effects of the invader and natives on soil nematodes under different CO_(2)concentrations and the relevant mechanism.The abundance of total soil nematodes and that of the dominant trophic group(herbivores)were significantly affected by plant species and CO_(2)concentration,and these effects were dependent on the experimental duration,however,the Shannon-diversity of nematodes was not affected by these factors.Under aCO_(2),both invasive and native species significantly increased the total nematode abundance and that of the dominant trophic group with increasing experimental duration,and the amplitude of the increase was greater under the invader relative to the natives.The eCO_(2)increased total nematode abundance(second year)and that of the dominant trophic group(third year)under the invader,but not under the natives(or even decreased)with increasing experimental duration.Root litter had greater effects on soil nematode abundance than leaf litter and root exudates did.This study indicates that eCO_(2)would aggravate effects of invasive plants on soil nematodes by increasing abundance,and these effects would vary with the duration.
文摘The associations of volatile organic compounds(VOCs)exposure with short sleep duration(SSD)have rarely been studied.We aimed to evaluate the correlation between VOC exposure and SSD risk,while also exploring the potential mediating influence of depressive symptoms.Blood concentrations of seven VOCs,namely benzene,toluene,ethylbenzene,m-/p-xylene,o-xylene,styrene(collectively known as BTEXS),and 1,4-dichlorobenzene,were analyzed in 2905 U.S.adults.Weighted logistic regression,quantile-based g-computation(QGC),and weighted quantile sum(WQS)regression were employed to investigate associations between selected VOCs and SSD risk.Mediation analyses were conducted to explore the potential mediating effects of depressive symptoms on these relationships.Increased blood levels of BTEXS were positively correlated with SSD risk,with odds ratios(OR)ranging from 1.130 to 1.212(all P<0.05).A nonlinear association between toluene concentration and SSD risk was observed(P for nonlinearity=0.028).Both QGC and WQS analyses indicated a positive association between co-exposure to VOCs and SSD,with styrene showing the highest positive weights(QGC:OR=1.313,95%confidence interval(CI):1.038–1.660;WQS:OR=1.386,95%CI:1.111–1.731).Furthermore,BTEXS exposure was positively linked to depressive symptoms,which in turn were significantly associated with SSD risk.Mediation analyses revealed that depressive symptoms partially mediated the relationships between individual and mixed VOCs and SSD risk,with mediation proportions ranging from 15.87%to 20.54%(all P<0.05).These findings indicated that exposure to VOCs increased SSD risk,with depressive symptoms playing a partial mediating role.
基金supported by Peking University,the National Natural Science Foundation of China,the National Institute on Aging and the World Bank。
文摘Background It remains unclear whether sleep duration and physical activity(PA)trajectories in middle-aged and older adults are associated with different risks of cardiovascular diseases(CVDs).This study aimed to explore the trajectories of total sleep duration and PA among middle-aged and older Chinese adults and their impact on CVD risk.Methods This study was based on the China Health and Retirement Longitudinal Study.12009 adults aged 45 years and older from five waves were included.CVD events were measured by self-reports of heart disease and stroke.We first used groupbased trajectory modeling to identify total sleep duration and PA trajectories from 2011 to 2020,and then employed logistic regression models to analyze their risk for CVD.Results We identified three sleep duration and PA trajectories.The risk of heart disease increased by 33%(OR=1.31,95%CI:1.12-1.53)for the short sleep duration trajectory(vs.moderate sleep duration trajectory),by 40%(OR=1.40,95%CI:1.06-1.84)for the high decreasing PA trajectory,and by 20%(OR=1.20,95%CI:1.01-1.42)for the low stable PA trajectory(vs.high stable PA trajectory),respectively.Similar results for stroke and CVD as the outcomes were also observed,but the higher risk of stroke in the high decreasing PA trajectory group was not statistically significant.The joint effects of sleep and PA showed lower risks of heart disease and stroke in trajectories with moderate or long sleep duration and high stable PA compared with short sleep duration and a low stable PA trajectory.Conclusions Short total sleep duration,high decreasing PA,and low stable PA trajectories could increase the risk of CVDs among middle-aged and older adults.Long-term moderate to long total sleep durations and high stable PA trajectories might be optimal for preventing CVDs.
基金supported by NSFC research Grant 42274200National Key R&D Program of China 2023YFC2808900the International Space Science Institute(ISSI)in Bern,through ISSI International Team project#24-628-Precipitation of Energetic Particles from Magnetosphere and Their Effects on the Atmosphere.
文摘Geomagnetic substorms release plasma and energy from the magnetotail to the inner magnetosphere and high latitude ionosphere.In this study,we investigate substorms of different time duration,observed during the years 1982 to 2012.We measure substorm duration by a method based on the SME index.Our results demonstrate that longer-duration substorms occur more frequently during solar maximum years,and more frequently between the months of May and July,likely due to the higher polar ionospheric conductivity and more sunward geomagnetic pole directions during summer in the northern hemisphere.Additionally,longer substorms occur more frequently under stronger,longer-lasting southward IMF,and are accompanied by slower solar winds,suggesting that extended magnetic reconnection is required to drive longer substorms.Substorm durations are not significantly related to the minimum SML index,but longer substorms usually have higher SMU and continuously rising PC indices.The SME indices of long-duration substorms show a bimodal MLT distribution located near midnight and dusk after substorm onset,with the peak originally at midnight moving eastward to the morning side during the late recovery phase.Longer duration substorms have a stronger effect on the overall ring current at all MLT sectors except dawnside.Our results provide new insights into the development process and influencing factors of substorms,from the expansion phase to the recovery phase.
基金supported by the National Key R&D Program of China(2021YFC2501500)National Natural Science Foundation of China(82171476)。
文摘Purpose:The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity(PA)with the risk of incident type 2 diabetes in a population-based prospective cohort study.Methods:Altogether,88,000 participants(mean age=62.2±7.9 years,mean±SD)were included from the UK Biobank.Sleep duration(short:<6 h/day;normal:6-8 h/day;long:>8 h/day)and PA of different intensities were measured using a wrist-won accelerometer over a 7-day period between 2013 and 2015.PA was classified according to the median or World Health Organization-recommendation:total volume of PA(high,low),moderate-to-vigorous PA(MVPA)(recommended,not recommended),and light-intensity PA(high,low).Incidence of type 2diabetes was ascertained using hospital records or death registries.Results:During a median follow-up of 7.0 years,1615 incident type 2 diabetes cases were documented.Compared with normal sleep duration,short(hazard ratio(HR)=1.21,95%confidence interval(95%CI):1.03-1.41)but not long sleep duration(HR=1.01,95%CI:0.89-1.15)was associated with excessive type 2 diabetes risk.This increased risk among short sleepers seems to be protected against by PA.Compared with normal sleepers with high or recommended PA,short sleepers with low volume of PA(HR=1.81,95%CI:1.46-2.25),not recommended(below the World Health Organization-recommended level of)MVPA(HR=1.92,95%CI:1.55-2.36),or low light-intensity PA(HR=1.49,95%CI:1.13-1.90)had a higher risk of type 2 diabetes,while short sleepers with a high volume of PA(HR=1.14,95%CI:0.88-1.49),recommended MVPA(HR=1.02,95%CI:0.71-1.48),or high light-intensity PA(HR=1.14,95%CI:0.92-1.41)did not.Conclusion:Accelerometer-measured short but not long sleep duration was associated with a higher risk of incident type 2 diabetes.A higher level of PA,regardless of intensity,potentially ameliorates this excessive risk.
基金the National Key R&D Program(Grant No.2019YFE0115200)Natural Science Foundation of China(Grants No.42071217).
文摘The surface solar radiation in most parts of the world has undergone a phenomenon known as global dimming and brightening,characterized by an initial decrease followed by an increase.As a result,the sunshine duration(SD)has decreased in the past 60 years.Against the backdrop of global dimming and brightening,SD has decreased to varying degrees in many regions of China.Using the observed data of SD,cloud amount(total cloud amount and low cloud amount,abbreviated as TCA and LCA),precipitation,and relative humidity(RH)from 34 meteorological stations in Chongqing during the period of 1961-2020,along with a digital elevation model(DEM)with a resolution of 90 m,this study analyzed the spatiotemporal variations and influencing factors of SD.The analysis employed methods such as linear regression,Mann-Kendall test,wavelet transformation,and DEM-based possible SD distributed model.The results showed that the annual SD in Chongqing has significantly decreased over the last 60 years,with a decreasing interannual trend rate(ITR)of 40.4 h/10a.Except for no obvious trend in spring,SD decreased significantly in summer,autumn and winter at the ITR of 21.1 h/10a,8.5 h/10a and 7.5 h/10a,respectively.An abrupt decrease in the annual SD was found in 1979.The difference before and after the abrupt decrease was 177.7 h.The difference before and after the abrupt decrease was 177.7 h.The annual SD possessed the oscillation period of 11a.The spatial heterogeneity of the mean annual SD during the last 60 years was obvious.The distribution of SD in Chongqing is high in the northeast and low in the southeast.In addition,about 73%of the total area in Chongqing showed a significant and very significant decreasing trend.The regions with significant changes are mainly concentrated in the regions with altitudes of 200~1000 m.The increasing LCA was the main cause of the decrease of the annual SD in the regions with 200-400 m altitude decreased the most and changed the most.Increasing LCA is the primary cause of the reduction in annual SD,showing a strong negative correlation coefficient of-0.7292.In Chongqing,PM2.5 concentration showed a significant decrease trend in annual,spring,autumn and winter during 2000-2020,but the significant correlation between PM2.5 concentration and SD was only in autumn and reached an extremely significant level.
文摘Objective:To explore the best duration of moxibustion on lumbar disk herniation(LDH).Methods:A total of 88 patients were randomly divided into control group and 15-min,30-min,and 45-min moxibustion groups.The control group was treated with conventional therapy,while the other 3 groups were intervened with different moxibustion durations.Low back pain,dysfunction,lumbar function,and effective rates were evaluated before,in the first week and second week of intervention.Results:In low back pain,compared with the control group,the score of the 15-min group had no significant difference,but it was significantly lower in the 30-min and 45-min groups.In dysfunction and lumbar function,compared with the control group,the scores of the 15-min,30-min,and 45-min groups were significantly higher,and the scores of the 30-min and 45-min groups were significantly higher,but there was no significant difference between the 30-min and 45-min group.In effective rates,there was no significant difference between the control group and 15-min group;the effective rates of the 30-min and 45-min groups were significantly higher than those of the control group.Conclusions:Moxibustion has good therapeutic effect on LDH with specific moxibustion time.
基金supported by the Joint Foundation of the Ministry of Education(Grant No.8091B022123)the Water Science and Technology Project of Jiangsu Province(Grant No.2022023)+1 种基金the Project of the Key Technologies of Port Engineering Construction under Medium and Long Period Wave Conditions(Grant No.ZJ2015-1)the Open Funding from the Key Laboratory of Port,Waterway and Sedimentation Engineering of the Ministry of Communications in 2023(Grant No.Yk223001-3).
文摘Coastal management in China is confronted with an urgent choice between natural restoration and maintenance of existing seawalls and reclaimed land for economic development.A key criterion for making this decision is the resilience to coastal flooding,which depends on the ability to predict tidal level.Tidal duration asymmetry(TDA)is a key parameter in determination of the arrival and duration of flood tides.This study selected the western inner shelf of the Yellow Sea(WYS)as the study area and investigated the responses of TDA to different shoreline configurations and relative sea level rise.The responses of TDA to shoreline reconstruction yielded spatial variability locally and remotely.In the nearshore area,the responses of TDA to the complex ocean environment mainly originated from the combined functions of reflection,bottom friction,and advection,which controlled the energy transfer from M2 or S2 constituents to their overtides or compound tides.The sensitivity of TDA to coastline typologies was not limited to coastal waters but could stretch over the entire inner shelf.The vulnerability of tidal responses was due to the displacement of the M2 amphidrome of the Kelvin wave on the WYS,which in turn changed tidal energy fluxes over the regime.The relative sea level rise could intensify the feedback of TDA to seawalls and land reclamation.
文摘Today,urban traffic,growing populations,and dense transportation networks are contributing to an increase in traffic incidents.These incidents include traffic accidents,vehicle breakdowns,fires,and traffic disputes,resulting in long waiting times,high carbon emissions,and other undesirable situations.It is vital to estimate incident response times quickly and accurately after traffic incidents occur for the success of incident-related planning and response activities.This study presents a model for forecasting the traffic incident duration of traffic events with high precision.The proposed model goes through a 4-stage process using various features to predict the duration of four different traffic events and presents a feature reduction approach to enable real-time data collection and prediction.In the first stage,the dataset consisting of 24,431 data points and 75 variables is prepared by data collection,merging,missing data processing and data cleaning.In the second stage,models such as Decision Trees(DT),K-Nearest Neighbour(KNN),Random Forest(RF)and Support Vector Machines(SVM)are used and hyperparameter optimisation is performed with GridSearchCV.In the third stage,feature selection and reduction are performed and real-time data are used.In the last stage,model performance with 14 variables is evaluated with metrics such as accuracy,precision,recall,F1-score,MCC,confusion matrix and SHAP.The RF model outperforms other models with an accuracy of 98.5%.The study’s prediction results demonstrate that the proposed dynamic prediction model can achieve a high level of success.
基金Supported by the Discipline Construction Project of Hunan University of Chinese Medicine,No.22JBZ002.
文摘This letter discusses the publication by Feng et al.Iodine,selenium,and vitamin D are closely associated with thyroid hormone production in humans;however,the efficacy of selenium and vitamin D supplementation for type 2 diabetes mellitus(T2DM)patients with Hashimoto’s thyroiditis(HT)remains controversial.In the retrospective study we discuss herein,the authors highlighted significant improvements in thyroid function,thyroid antibodies,blood glucose,and blood lipid in T2DM patients with HT following addition of vitamin D and selenium to their antidiabetic regimens,underscoring the value of these supplements.Our team is currently engaged in research exploring the relationship between micronutrients and HT,and we have obtained invaluable insights from the aforementioned study.Based on this research and current literature,we recommend a regimen of 4000 IU/day of vitamin D and 100-200μg/day of selenium for over three months to six months for patients with HT,particularly for those with concurrent T2DM.
文摘Neonates,especially admitted to neonatal intensive care unit,frequently need various medical interventions in their early days.A common procedure is the heel prick for blood sampling.Although necessary for diagnosis,this procedure can be stressful for neonates,causing pain,extended crying,and discomfort.Reducing distress in neonates during such procedures is important for the well‐being of neonates and the satisfaction of caregivers and healthcare providers.Therefore,this review aims to identify and compare the efficacy of 25%dextrose and breast milk on pain and duration of cry among neonates during heel-lance.As part of its review process,the article examined widely used databases,including PubMed,EMBASE,Cochrane,Academia,and Google Scholar.For the meta-analysis,the authors utilized RevMan 5.4.All eligible trials were analyzed using the Cochrane Risk of Bias Tool to assess the quality of the included studies and evaluate the risk of bias.Out of 131 studies reviewed,seven studies were included in meta-analysis of pain,and four studies were included in duration of cry.The results show that 25%dextrose is more effective to reduce pain among neonates during minor invasive procedure like heel prick(P<0.00001),whereas both interventions are effective in the reduction of crying duration.This review highlights that dextrose is more effective in reducing pain in comparison to breast milk.However,additional well-designed studies with larger sample sizes and extended follow-up periods are needed to validate and build upon the current findings.Hence,this review underscores the importance of utilizing effective pain management strategies,such as 25%dextrose,to enhance neonatal care and improve the overall well-being of newborns during invasive procedures.
