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 This study aimed to determine the temporal trends in sleep duration among Chinese adults.Methods In this series of repeated nationally representative cross-sectional surveys(China Chronic Disease and Risk Fa...Objective This study aimed to determine the temporal trends in sleep duration among Chinese adults.Methods In this series of repeated nationally representative cross-sectional surveys(China Chronic Disease and Risk Factors Surveillance)conducted between 2010 and 2018,a total of 645,420 adult participants(97,741 in 2010;175,749 in 2013;187,777 in 2015;and 184,153 in 2018)were included in the trend analysis.Linear and logistic regression models were utilized to assess trends in sleep duration.Results In 2018,the estimated overall mean sleep duration among the Chinese adult population was7.58(SD,1.45)hours per day,with no significant trend from 2010.A significant increase in short sleep duration(≤6 hours)was observed in the total population,from 15.3%(95%CI:14.1%–16.5%)in 2010 to18.5%(95%CI:17.7%–19.3%)in 2018(P<0.001).Similarly,the trend in long sleep duration(>9 hours)was also significant,increasing in weighted prevalence from 7.2%(95%CI:6.3%–8.1%)in 2010 to 9.0%(95%CI:8.2%–9.9%)in 2018(P<0.001).Conclusion The prevalence of both short and long sleep durations significantly increased among Chinese adults from 2010 to 2018,highlighting the urgency of health initiatives to promote optimal sleep duration in China.展开更多
AIM:To explore the factors influencing the treatment duration and visual prognosis of cytomegalovirus(CMV)retinitis(CMVR)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).METHODS:All participants rec...AIM:To explore the factors influencing the treatment duration and visual prognosis of cytomegalovirus(CMV)retinitis(CMVR)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).METHODS:All participants received ganciclovir intravenous infusion or oral and intravitreal injection of ganciclovir(IVG)3 mg twice a week for 4 consecutive times(induction phase).The affected eyes were divided into stop treatment group(Group A),continue treatment group(Group B),and relapse after treatment group(Group C)according to whether local therapy could be terminated at the end of the induction phase and whether CMVR recurred within 3mo after the termination of local therapy.RESULTS:The study included 31 participants(48 eyes)diagnosed with CMVR including 11 males and 20 females.The mean age was(28±8.2)y.There were 17 cases of binocular disease(34 eyes)and 14 cases of monocular disease(14 eyes).Visual acuity improved in 26 eyes(54.1%),remained unchanged in 9 eyes(18.8%),and decreased in 13 eyes(27.1%).The peak value of blood CMV in Group B was significantly higher than that in Group A(P=0.013).The number of eyes with anterior chamber inflammation in Group C was significantly lower than that in Groups A and B(P=0.015,P=0.016).The average number of interval days was higher in Group A than in Group B.For Group A,there was a strong positive correlation between the number of eyes with CMV positive blood(r=0.712,P=0.031)and visual acuity changes.For Group B,there was a moderately strong positive correlation between the days of blood CMV after transplantation(r=0.371,P=0.043)and the times of injections.For Group C,there was a strong positive correlation between the peak value of blood CMV(r=0.719,P=0.029)and the times of injection.CONCLUSION:Systemic use of antivirals combined with intravitreal injection of antivirals is effective for patients with CMVR after allo-HSCT surgery.Patients with shorter interval days,higher peak or more days of blood CMV need more injections.Patients with positive blood CMV at initial diagnosis have worse visual prognosis.展开更多
To assess the effect of the injection duration of subcutaneous low-molecular-weight heparin(LMWH)on pain and bruising in patients.Randomized controlled trials and quasiexperimental studies were searched for in four el...To assess the effect of the injection duration of subcutaneous low-molecular-weight heparin(LMWH)on pain and bruising in patients.Randomized controlled trials and quasiexperimental studies were searched for in four electronic databases.The pooled effect size was expressed as relative risk(RR)andmeandifference(MD)with95%confidence intervals(CI)for dichotomous and continuous data.Cochrane Q and p value were used to assess heterogeneity and the I2 statistic was adopted to quantify the level.Finally,eight studies involving a total of 532 participants met our inclusion criteria.The slow(30 second)injection was associated with a reduction in pain intensity and duration,and lower bruising occurrence at 48-72 hours and 48 hours post injection.The bruising area was also smaller at 48 hours and 60 hours post injection.Nodifferenceswere identified betweenthe slowand fast(10 second)injectionin bruising area and bruising occurrence at 24 hours and 60 hours post injection.With present evidences,slow injection of LMWH is beneficial to the patient's well being,but further studies to identify the feasibility and standardization of the technique is recommended.展开更多
In this paper,the influence of ground motion duration on the inelastic displacement ratio,C_(1),of highly damped SDOF systems is studied.For this purpose,two sets of spectrally equivalent long and short duration groun...In this paper,the influence of ground motion duration on the inelastic displacement ratio,C_(1),of highly damped SDOF systems is studied.For this purpose,two sets of spectrally equivalent long and short duration ground motion records were used in an analysis to isolate the effects of ground motion duration on.The effect of duration was evaluated for observed values of C_(1) by considering six ductility levels,and different damping and post-yield stiffness ratios.A new predictive equation of C_(1) also was developed for long and short duration records.Results of non-linear regression analysis of the current study provide an expression with which to quantify the duration effect.Based on the average values of estimated C_(1) ratios for long duration records divided by C_(1) for a short duration set,it is concluded that the maximum difference between long and short duration records occurs when the damping ratio is 0.3 and the post-yield stiffness ratio is equal to zero.展开更多
Objective:The Holmium:yttrium-aluminum-garnet(Ho:YAG)laser is the standard lithotrite for ureteroscopy.This paper is to evaluate a Ho:YAG laser with a novel effect function in vitro,which allows a real-time variation ...Objective:The Holmium:yttrium-aluminum-garnet(Ho:YAG)laser is the standard lithotrite for ureteroscopy.This paper is to evaluate a Ho:YAG laser with a novel effect function in vitro,which allows a real-time variation of pulse duration and pulse peak power.Methods:Two types of phantom calculi with four degrees of hardness were made for fragmentation and retropulsion experiments.Fragmentation was analysed at 5(0.5 J/10 Hz),10(1 J/10 Hz),and 20(2 J/10 Hz)W in non-floating phantom calculi,retropulsion in an ureteral model at 10(1 J/10 Hz)and 20(2 J/10 Hz)W using floating phantom calculi.The effect function was set to 25%,50%,75%,and 100%of the maximum possible effect function at each power setting.Primary outcomes:fragmentation(mm^3),the distance of retropulsion(cm);5 measurements for each trial.Results:An increase of the effect feature(25%vs.100%),i.e.,an increase of pulse peak power and decrease of pulse duration,improved Ho:YAG laser fragmentation.This effect was remarkable in soft stone composition,while there was a trend for improved fragmentation with an increase of the effect feature in hard stone composition.Retropulsion increased with increasing effect function,independently of stone composition.The major limitations of the study are the use of artificial stones and the in vitro setup.Conclusion:Changes in pulse duration and pulse peak power may lead to improved stone fragmentation,most prominently in soft stones,but also lead to increased retropulsion.This new effect function may enhance Ho:YAG laser fragmentation when maximum power output is limited or retropulsion is excluded.展开更多
Background: Although coronary heart disease (CHD) is the most common cause of death worldwide the literature shows a wide variation in the arrangement of cardiac rehabilitation and achieved lifestyle changes. Aim: The...Background: Although coronary heart disease (CHD) is the most common cause of death worldwide the literature shows a wide variation in the arrangement of cardiac rehabilitation and achieved lifestyle changes. Aim: The purpose of this study was to evaluate the effects of intensity (number of patient follow-ups), duration (length of intervention) and content in cardiac rehabilitation programs (CRP) regarding lifestyle changes in patients with CHD. Method: A systematic literature review of articles published in the databases PubMed and CINAHL between 1990 and 2007 was conducted. This resulted in 1120 hits of which 25 articles finally met the set criteria for inclusion. Results: The majority of significant positive results on lifestyle factors were shown among the studies describing high intensity and long duration. Included studies showed a wide variation in content, but four different interventions (informative content, educational content, practical content, behavioral and self care-oriented content) emerged. The group of studies which contained all four interventions focused on most lifestyle factors and achieved the most significant positive results. Conclusion: This systematic literature review shows that CRP should include high intensity, long duration and an intervention content covering information, knowledge, practical training, self care-activity and behavior changes in order to achieve effect on all four lifestyle factors of diet, physical activity and exercise, smoking and stress. Lifestyle changes can be reached in less lifestyle factors, with a longer duration and a variation of intensity of contacts but in combining with an informative and educational content with an additional content of a practical nature or self activity.展开更多
We consider the verification problem of invariance properties for timedsystems modeled by (extended) Timed Graphs with duration variables. This problem is in general caseundecidable. Nevertheless we give in this paper...We consider the verification problem of invariance properties for timedsystems modeled by (extended) Timed Graphs with duration variables. This problem is in general caseundecidable. Nevertheless we give in this paper a technique extending a given system into anotherone containing the initial computations as well as additional ones. Then we define a digitizationtechnique allowing the translation from the continuous case to the discrete one. Using thisdigitization, we show that to each real computation in the initial system corresponds a discretecomputation in the extended system. Then, we show that the extended system corresponds to a veryclose approximation of the initial one, allowing per consequent, a good analysis of invarianceproperties of the initial system.展开更多
Objective:To observe whether the Ear Well infant ear correction system makes any difference in terms of the treatment effect,duration,complication rate,and nursing care requirements in different types of infant auricl...Objective:To observe whether the Ear Well infant ear correction system makes any difference in terms of the treatment effect,duration,complication rate,and nursing care requirements in different types of infant auricle deformities.Methods:A total of 93 infant patients with auricular deformity(age:<3 months of age)who were diagnosed and treated in Guangzhou Children and Women’s Medical Center from April 2018 to September 2020 were selected and treated with the Ear Well infant ear correction system.We observed and recorded the effects of the Ear Well infant ear correction system,the treatment duration,the number of rebound cases,and complications that are likely to occur during treatment,and noted the related factors causing complications and the relative requirements for nursing care.Results:The Earwell infant ear correction system could effectively correct infant auricle deformities.Among the 93 cases,90 cases had positive therapeutical outcome and the effective rate was 96.77%.The treatment duration for lop ear and protruding ear was longer than for other auricle deformities;the deformity recoil and the treatment compilation rates were much higher for these 2 deformity types,and the difference was statistically significant(P<0.05).Conclusions:The treatment suggestion for the wearing duration of the Ear Well infant ear correction system for lop ear and protruding ear is a prolonged duration compared with that for other infant auricle deformities.Fur ther,the requirements for nursing care intensity and infant patient’s guardian’s nursing knowledge and skill are obviously increased for these 2 types of auricle deformities.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
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
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
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
To investigate the influence of non-uniform water distribution on the mechanical properties and failure behavior of red sandstone,we designed five immersion heights and durations to achieve varying non-uniform water d...To investigate the influence of non-uniform water distribution on the mechanical properties and failure behavior of red sandstone,we designed five immersion heights and durations to achieve varying non-uniform water distribution states.Uniaxial compression tests were conducted on red sandstone under these conditions.The effects of non-uniform water distribution on deformation,failure,strength,and energy characteristics of red sandstone were analyzed.The impact of non-uniform water distribution on the intensity of rock failure was discussed,and the failure mechanism under non-uniform water distribution was revealed.The hazards of low immersion heights on underground rock structures were analyzed.The results demonstrate that peak strength and elastic modulus of red sandstone exhibit high sensitivity to immersion height,with reductions of 38%and 23%respectively even at L=1/50H.Water immersion reduces both energy storage capacity and energy dissipation capability of red sandstone.The immersion height and duration influence the failure mode of red sandstone by controlling the migration and separation of dry-wet interfaces.Low immersion height poses significant risks to underground rock structures(e.g.,a 38%strength reduction when L=1/50H),and the concentration degree of water non-uniform distribution is the key factor in assessing the weakening effect of water on rocks.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
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
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
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
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
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 National Natural Science Foundation of China(82341245,82371491)the Chinese Central Government(Key Project of Public Health Program)the National Key Research and Development Program of China(2018YFC1311706,2018YFC1311702)。
文摘Objective This study aimed to determine the temporal trends in sleep duration among Chinese adults.Methods In this series of repeated nationally representative cross-sectional surveys(China Chronic Disease and Risk Factors Surveillance)conducted between 2010 and 2018,a total of 645,420 adult participants(97,741 in 2010;175,749 in 2013;187,777 in 2015;and 184,153 in 2018)were included in the trend analysis.Linear and logistic regression models were utilized to assess trends in sleep duration.Results In 2018,the estimated overall mean sleep duration among the Chinese adult population was7.58(SD,1.45)hours per day,with no significant trend from 2010.A significant increase in short sleep duration(≤6 hours)was observed in the total population,from 15.3%(95%CI:14.1%–16.5%)in 2010 to18.5%(95%CI:17.7%–19.3%)in 2018(P<0.001).Similarly,the trend in long sleep duration(>9 hours)was also significant,increasing in weighted prevalence from 7.2%(95%CI:6.3%–8.1%)in 2010 to 9.0%(95%CI:8.2%–9.9%)in 2018(P<0.001).Conclusion The prevalence of both short and long sleep durations significantly increased among Chinese adults from 2010 to 2018,highlighting the urgency of health initiatives to promote optimal sleep duration in China.
文摘AIM:To explore the factors influencing the treatment duration and visual prognosis of cytomegalovirus(CMV)retinitis(CMVR)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).METHODS:All participants received ganciclovir intravenous infusion or oral and intravitreal injection of ganciclovir(IVG)3 mg twice a week for 4 consecutive times(induction phase).The affected eyes were divided into stop treatment group(Group A),continue treatment group(Group B),and relapse after treatment group(Group C)according to whether local therapy could be terminated at the end of the induction phase and whether CMVR recurred within 3mo after the termination of local therapy.RESULTS:The study included 31 participants(48 eyes)diagnosed with CMVR including 11 males and 20 females.The mean age was(28±8.2)y.There were 17 cases of binocular disease(34 eyes)and 14 cases of monocular disease(14 eyes).Visual acuity improved in 26 eyes(54.1%),remained unchanged in 9 eyes(18.8%),and decreased in 13 eyes(27.1%).The peak value of blood CMV in Group B was significantly higher than that in Group A(P=0.013).The number of eyes with anterior chamber inflammation in Group C was significantly lower than that in Groups A and B(P=0.015,P=0.016).The average number of interval days was higher in Group A than in Group B.For Group A,there was a strong positive correlation between the number of eyes with CMV positive blood(r=0.712,P=0.031)and visual acuity changes.For Group B,there was a moderately strong positive correlation between the days of blood CMV after transplantation(r=0.371,P=0.043)and the times of injections.For Group C,there was a strong positive correlation between the peak value of blood CMV(r=0.719,P=0.029)and the times of injection.CONCLUSION:Systemic use of antivirals combined with intravitreal injection of antivirals is effective for patients with CMVR after allo-HSCT surgery.Patients with shorter interval days,higher peak or more days of blood CMV need more injections.Patients with positive blood CMV at initial diagnosis have worse visual prognosis.
文摘To assess the effect of the injection duration of subcutaneous low-molecular-weight heparin(LMWH)on pain and bruising in patients.Randomized controlled trials and quasiexperimental studies were searched for in four electronic databases.The pooled effect size was expressed as relative risk(RR)andmeandifference(MD)with95%confidence intervals(CI)for dichotomous and continuous data.Cochrane Q and p value were used to assess heterogeneity and the I2 statistic was adopted to quantify the level.Finally,eight studies involving a total of 532 participants met our inclusion criteria.The slow(30 second)injection was associated with a reduction in pain intensity and duration,and lower bruising occurrence at 48-72 hours and 48 hours post injection.The bruising area was also smaller at 48 hours and 60 hours post injection.Nodifferenceswere identified betweenthe slowand fast(10 second)injectionin bruising area and bruising occurrence at 24 hours and 60 hours post injection.With present evidences,slow injection of LMWH is beneficial to the patient's well being,but further studies to identify the feasibility and standardization of the technique is recommended.
文摘In this paper,the influence of ground motion duration on the inelastic displacement ratio,C_(1),of highly damped SDOF systems is studied.For this purpose,two sets of spectrally equivalent long and short duration ground motion records were used in an analysis to isolate the effects of ground motion duration on.The effect of duration was evaluated for observed values of C_(1) by considering six ductility levels,and different damping and post-yield stiffness ratios.A new predictive equation of C_(1) also was developed for long and short duration records.Results of non-linear regression analysis of the current study provide an expression with which to quantify the duration effect.Based on the average values of estimated C_(1) ratios for long duration records divided by C_(1) for a short duration set,it is concluded that the maximum difference between long and short duration records occurs when the damping ratio is 0.3 and the post-yield stiffness ratio is equal to zero.
文摘Objective:The Holmium:yttrium-aluminum-garnet(Ho:YAG)laser is the standard lithotrite for ureteroscopy.This paper is to evaluate a Ho:YAG laser with a novel effect function in vitro,which allows a real-time variation of pulse duration and pulse peak power.Methods:Two types of phantom calculi with four degrees of hardness were made for fragmentation and retropulsion experiments.Fragmentation was analysed at 5(0.5 J/10 Hz),10(1 J/10 Hz),and 20(2 J/10 Hz)W in non-floating phantom calculi,retropulsion in an ureteral model at 10(1 J/10 Hz)and 20(2 J/10 Hz)W using floating phantom calculi.The effect function was set to 25%,50%,75%,and 100%of the maximum possible effect function at each power setting.Primary outcomes:fragmentation(mm^3),the distance of retropulsion(cm);5 measurements for each trial.Results:An increase of the effect feature(25%vs.100%),i.e.,an increase of pulse peak power and decrease of pulse duration,improved Ho:YAG laser fragmentation.This effect was remarkable in soft stone composition,while there was a trend for improved fragmentation with an increase of the effect feature in hard stone composition.Retropulsion increased with increasing effect function,independently of stone composition.The major limitations of the study are the use of artificial stones and the in vitro setup.Conclusion:Changes in pulse duration and pulse peak power may lead to improved stone fragmentation,most prominently in soft stones,but also lead to increased retropulsion.This new effect function may enhance Ho:YAG laser fragmentation when maximum power output is limited or retropulsion is excluded.
文摘Background: Although coronary heart disease (CHD) is the most common cause of death worldwide the literature shows a wide variation in the arrangement of cardiac rehabilitation and achieved lifestyle changes. Aim: The purpose of this study was to evaluate the effects of intensity (number of patient follow-ups), duration (length of intervention) and content in cardiac rehabilitation programs (CRP) regarding lifestyle changes in patients with CHD. Method: A systematic literature review of articles published in the databases PubMed and CINAHL between 1990 and 2007 was conducted. This resulted in 1120 hits of which 25 articles finally met the set criteria for inclusion. Results: The majority of significant positive results on lifestyle factors were shown among the studies describing high intensity and long duration. Included studies showed a wide variation in content, but four different interventions (informative content, educational content, practical content, behavioral and self care-oriented content) emerged. The group of studies which contained all four interventions focused on most lifestyle factors and achieved the most significant positive results. Conclusion: This systematic literature review shows that CRP should include high intensity, long duration and an intervention content covering information, knowledge, practical training, self care-activity and behavior changes in order to achieve effect on all four lifestyle factors of diet, physical activity and exercise, smoking and stress. Lifestyle changes can be reached in less lifestyle factors, with a longer duration and a variation of intensity of contacts but in combining with an informative and educational content with an additional content of a practical nature or self activity.
文摘We consider the verification problem of invariance properties for timedsystems modeled by (extended) Timed Graphs with duration variables. This problem is in general caseundecidable. Nevertheless we give in this paper a technique extending a given system into anotherone containing the initial computations as well as additional ones. Then we define a digitizationtechnique allowing the translation from the continuous case to the discrete one. Using thisdigitization, we show that to each real computation in the initial system corresponds a discretecomputation in the extended system. Then, we show that the extended system corresponds to a veryclose approximation of the initial one, allowing per consequent, a good analysis of invarianceproperties of the initial system.
文摘Objective:To observe whether the Ear Well infant ear correction system makes any difference in terms of the treatment effect,duration,complication rate,and nursing care requirements in different types of infant auricle deformities.Methods:A total of 93 infant patients with auricular deformity(age:<3 months of age)who were diagnosed and treated in Guangzhou Children and Women’s Medical Center from April 2018 to September 2020 were selected and treated with the Ear Well infant ear correction system.We observed and recorded the effects of the Ear Well infant ear correction system,the treatment duration,the number of rebound cases,and complications that are likely to occur during treatment,and noted the related factors causing complications and the relative requirements for nursing care.Results:The Earwell infant ear correction system could effectively correct infant auricle deformities.Among the 93 cases,90 cases had positive therapeutical outcome and the effective rate was 96.77%.The treatment duration for lop ear and protruding ear was longer than for other auricle deformities;the deformity recoil and the treatment compilation rates were much higher for these 2 deformity types,and the difference was statistically significant(P<0.05).Conclusions:The treatment suggestion for the wearing duration of the Ear Well infant ear correction system for lop ear and protruding ear is a prolonged duration compared with that for other infant auricle deformities.Fur ther,the requirements for nursing care intensity and infant patient’s guardian’s nursing knowledge and skill are obviously increased for these 2 types of auricle deformities.
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.
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 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 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.
基金supported by the National Natural Science Foundation of China(Nos.52474133,52304227,52304091,and 52374095)the Natural Science Foundation of Hunan Province(Nos.2025JJ50316 and 2023JJ40548).
文摘To investigate the influence of non-uniform water distribution on the mechanical properties and failure behavior of red sandstone,we designed five immersion heights and durations to achieve varying non-uniform water distribution states.Uniaxial compression tests were conducted on red sandstone under these conditions.The effects of non-uniform water distribution on deformation,failure,strength,and energy characteristics of red sandstone were analyzed.The impact of non-uniform water distribution on the intensity of rock failure was discussed,and the failure mechanism under non-uniform water distribution was revealed.The hazards of low immersion heights on underground rock structures were analyzed.The results demonstrate that peak strength and elastic modulus of red sandstone exhibit high sensitivity to immersion height,with reductions of 38%and 23%respectively even at L=1/50H.Water immersion reduces both energy storage capacity and energy dissipation capability of red sandstone.The immersion height and duration influence the failure mode of red sandstone by controlling the migration and separation of dry-wet interfaces.Low immersion height poses significant risks to underground rock structures(e.g.,a 38%strength reduction when L=1/50H),and the concentration degree of water non-uniform distribution is the key factor in assessing the weakening effect of water on rocks.
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.
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.
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.
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.
