Extending the retirement age is an inevitable trend with the extension of the life expectancy of the population, reducing the financial burden of pensions, increasing the utilization rate of human capital, alleviating...Extending the retirement age is an inevitable trend with the extension of the life expectancy of the population, reducing the financial burden of pensions, increasing the utilization rate of human capital, alleviating the shortage of the labor market and other social problems. More and more countries are beginning to impose extended retirement policies, like United States, South Korea, Canada and Nordic countries and so on, all have taken some measures to delay retirement. However, the general social recognition is not high. Both the aged group, the education level and the individual＇s lifestyle have a significant impact on the delayed retirement age policy. Severe aging situation puts the future pension system at risk, based on the interests of the country, delayed retirement will help utilize the human capital and relieve the country＇ s financial pressure; from individual perspective, extending retirement age can help reduce the provision for the aged people. This article based on previous literatures review, through conducted the survey of people in Halmstad to analyze the local citizen＇s perception on delayed retirement and the influencing factors behind. Concluded that willingness of delayed retirement among people is not very high, reasons vary from different kinds of people.展开更多
Background There is little information on the factors that have influenced the long-term success rate of radiofrequency ablation of ventricular arrhythmias(VAs)at different targets.The objective of this study was to i...Background There is little information on the factors that have influenced the long-term success rate of radiofrequency ablation of ventricular arrhythmias(VAs)at different targets.The objective of this study was to investigate the characteristics of the ablation of VAs and the factors influencing the long-term success rate in our center.Methods Totally,2751 consecutive patients(mean ages 44±15 years,male/female 58.6%/41.4%)with VAs underwent radiofrequency ablation in Guangdong Provincial People’s Hospital from 2013 to 2018 were analyzed.Baseline data were retrieved from the medical record system.Long-term follow-up data were obtained by telephone interview.We mainly recorded the patient’s last post-ablation holter,and the symptoms after ablation.Multivariable regressions were applied to assess the relationship between the long-term success rate and the influence factors.Results Through the baseline data of 2751 patients,we found that the acute success rate of ablation was 95.1%.The average follow-up time was 16±5 months(ranging from 1 to 80).In all,304 patients(11%)lost follow-up,while 2447 patients(89%)were successfully followed.The long-term success rate of ablation was 82.56%.By means of multivariable regression analyses,it was discovered that cardiovascular diseases,such as coronary heart disease(OR:0.568,95%CI:0.327-0.987),hypertension(OR:1.554,95%CI:1.100-2.198),were independently associated with the long-term success rate,as well as ablation approaches(OR:0.212,95%CI:0.082-0.550).Lower ablation success rates of the patients whose VAs were originated from some uncommon region,like left ventricular papillary muscle,Summit,etc.were observed.Conclusions Ablation approaches,concomitant cardiovascular diseases,and ablation targets were related to the long-term clinical outcome of VAs ablation.展开更多
This paper deals with the shape and influenced factors of surface non-continuous deformation due to mining. With finite element method, analysis are made to derive the relations between discontinuous deformation and m...This paper deals with the shape and influenced factors of surface non-continuous deformation due to mining. With finite element method, analysis are made to derive the relations between discontinuous deformation and mining affection, weak plane’s position & thickness, and mechanical property of weak-plane medium. The mutual affection of multiple weak-planes is also discussed. The results of the paper lay a foundation for constructing the calculation method of surface discontinuous deformation.展开更多
Tuberculosis(TB),one of the oldest infectious diseases caused by Mycobacterium tuberculosis,poses a considerable challenge to global public health.There are approximately 10 million new TB cases worldwide annually,and...Tuberculosis(TB),one of the oldest infectious diseases caused by Mycobacterium tuberculosis,poses a considerable challenge to global public health.There are approximately 10 million new TB cases worldwide annually,and TB claims the lives of nearly 3 million people each year,making it one of the leading causes of death from a single infectious disease[1].China ranks third globally in terms of TB burden,with approximately 733,000 TB cases reported in 2023[2].Based on the ecological model of health determinants developed by Whitehead and Dahlgren,health determinants can be classified into direct causes.展开更多
The discharge of micro-polluted water from sources such as agricultural runoff,urban stormwater,and treated effluents presents significant challenges to aquatic ecosystems.Constructed wetlands(CWs)have gained recog-ni...The discharge of micro-polluted water from sources such as agricultural runoff,urban stormwater,and treated effluents presents significant challenges to aquatic ecosystems.Constructed wetlands(CWs)have gained recog-nition as an eco-friendly solution for removing pollutants from various wastewater sources and are increasingly applied for micro-polluted water treatment.By reviewing 78 full-scale CW studies from Web of Science,it is summarized that the ranges of ammonium nitrogen(NH4+-N)concentrations in runoff,wastewater treatment plant effluent and polluted river were 0.1–6.6,0.3–12.3,and 0.2–41.1 mg/L,respectively.The ranges of ni-trate nitrogen concentrations were 0.2–14.2,0–5.7,and 0–2.6 mg/L,respectively.Removal efficiencies of CWs for micro-polluted water varied by CW types.The total nitrogen removal efficiencies for subsurface-flow CWs,free-water surface-flow CWs,and hybrid CWs ranged from 27.4%to 66.5%,16.8%to 89.8%,and 19.4%to 88.2%,respectively.The NH4+-N removal efficiencies ranged from 34.2%to 73.6%,38.4%to 89.4%and 13.5%to 94.2%,respectively.Additionally,other factors influencing contaminant removal efficiency such as hydraulic retention time,vegetation types,redox micro-environment and influent water quality were evaluated.Based on these findings,two strategies for improving the purification performance of CWs were proposed:the selection of incorporating electron donor substrates and the optimization of operation parameters.This paper serves as a synthesis of information to guide future research and full-scale CW applications in micro-polluted water treatment.展开更多
This paper provides a systematic review of the histochemical localization,content characteristics,and influencing factors of saponins in Pseudostellaria heterophylla based on an extensive literature survey.It provides...This paper provides a systematic review of the histochemical localization,content characteristics,and influencing factors of saponins in Pseudostellaria heterophylla based on an extensive literature survey.It provides an in-depth analysis and summary of the effects of biological factors,environmental conditions,agronomic practices,processing methods,and continuous cropping obstacles on the synthesis of P.heterophylla saponins,as well as their underlying mechanisms.Based on identified gaps in the current literature,future research directions and prospects are proposed.The findings of this review offer valuable insights for advancing the understanding of the saponin biosynthesis mechanisms in P.heterophylla and for enhancing its quality.展开更多
Background:The trajectory of intrinsic capacity(IC)among the older population is characterized by its diversity and is predictive of adverse health outcomes such as disability,nursing home admission,decline in quality...Background:The trajectory of intrinsic capacity(IC)among the older population is characterized by its diversity and is predictive of adverse health outcomes such as disability,nursing home admission,decline in quality of life,and mortality.Gaining an understanding of the trajectory of IC and the factors that influence it is of paramount importance for fostering healthy aging.This research is focused on exploring the trajectory of IC among older adults in China and examining the factors that influence it.Methods:This observational longitudinal cohort study leveraged data from the China Health and Retirement Longitudinal Study(CHARLS),which was conducted in the years 2011,2013,and 2015.For the purpose of this analysis,a total of 2,233 participants who were aged 60 and over were included.A Growth Mixture Model(GMM)was utilized to define trajectory categories for IC.Influential factors were ascertained based on the health ecology model,and binary logistic regression analysis was utilized to investigate the factors linked with the different trajectory categories.Results:Two distinct trajectory classes of IC were identified:Class 1,the normal-stable group,encompassed 90.4%of the elderly population,while Class 2,the declining group,made up 9.6%.Advanced age and a history of stroke were found to be significantly associated with Class 2.High scores in activities of daily living(ADL),employment status,receiving primary or junior high school education,and residence in the East or Central regions of China were significantly linked with Class 1.Conclusion:The trajectory of IC among older Chinese adults is marked by its heterogeneity.Advanced age and a history of stroke are significant risk factors for a declining IC trajectory,while higher ADL scores,being employed,receiving primary or junior high school education,and residing in the East or Central regions of China are protective factors associated with a stable IC trajectory.Healthcare institutions must closely monitor IC levels and understand these trajectory patterns to implement personalized and targeted interventions promptly to maintain IC at a healthy level and advocate for healthy aging.展开更多
BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery...BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery speed and quality of life.Effective prevention of anxiety and depression in elderly patients has become an urgent problem.AIM To investigate the trajectory of anxiety and depression levels in elderly patients after LIF,and the influencing factors.METHODS Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital.General information and surgery-related indices were recorded,and participants completed measures of psychological status,lumbar spine dysfunction,and quality of life.A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels,and unordered multi-categorical logistic regression was used to analyze the influencing factors.RESULTS Three trajectories of change in anxiety level were identified:Increasing anxiety(n=26,10.88%),decreasing anxiety(n=27,11.30%),and stable anxiety(n=186,77.82%).Likewise,three trajectories of change in depression level were identified:Increasing depression(n=30,12.55%),decreasing depression(n=26,10.88%),and stable depression(n=183,76.57%).Regression analysis showed that having no partner,female sex,elevated Oswestry dysfunction index(ODI)scores,and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels,whereas female sex,postoperative opioid use,and elevated ODI scores all contributed to increased depression levels.CONCLUSION During clinical observation,combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention,quickens recovery,and enhances quality of life.展开更多
Based on raw data from dams damaged in the Wenchuan earthquake, including many that were severely damaged, characteristics and factors that influenced the damage are discussed in this paper. Findings from this study i...Based on raw data from dams damaged in the Wenchuan earthquake, including many that were severely damaged, characteristics and factors that influenced the damage are discussed in this paper. Findings from this study include： severely damaged dams were densely distributed along the seismologic fault; small dams, especially small earth-rock dams, had the most serious damage that was caused by a variety of factors; the most serious damage was caused by seismic waves; damage was aggregated by aftershocks; and the extent of the damage patterns increased with the seismic intensity. Damage patterns varied in different intensity zones and cracking was the most common type of damage. Most of the dams had a good base with relatively high bearing capacity, and the walls of the earth-rock dams were mostly of clay soil. This type of base and body material mitigated some of the damage to dams. Reservoir maintenance and other factors also have a significant impact on the seismic safety of the dam. Finally, some recommendations to reduce seismic damage to dams are proposed.展开更多
BACKGROUND At present,the influencing factors of social function in patients with residual depressive symptoms are still unclear.Residual depressive symptoms are highly harmful,leading to low mood in patients,affectin...BACKGROUND At present,the influencing factors of social function in patients with residual depressive symptoms are still unclear.Residual depressive symptoms are highly harmful,leading to low mood in patients,affecting work and interpersonal communication,increasing the risk of recurrence,and adding to the burden on families.Studying the influencing factors of their social function is of great significance.AIM To explore the social function score and its influencing factors in patients with residual depressive symptoms.METHODS This observational study surveyed patients with residual depressive symptoms(case group)and healthy patients undergoing physical examinations(control group).Participants were admitted between January 2022 and December 2023.Social functioning was assessed using the Sheehan Disability Scale(SDS),and scores were compared between groups.Factors influencing SDS scores in patients with residual depressive symptoms were analyzed by applying multiple linear regression while using the receiver operating characteristic curve,and these RESULTS The SDS scores of the 158 patients with depressive symptoms were 11.48±3.26.Compared with the control group,the SDS scores and all items in the case group were higher.SDS scores were higher in patients with relapse,discon-tinuous medication,drug therapy alone,severe somatic symptoms,obvious residual symptoms,and anxiety scores≥8.Disease history,medication compliance,therapy method,and residual symptoms correlated positively with SDS scores(r=0.354,0.414,0.602,and 0.456,respectively).Independent influencing factors included disease history,medication compliance,therapy method,somatic symptoms,residual symptoms,and anxiety scores(P<0.05).The areas under the curve for predicting social functional impairment using these factors were 0.713,0.559,0.684,0.729,0.668,and 0.628,respectively,with sensitivities of 79.2%,61.8%,76.8%,81.7%,63.6%,and 65.5%and specificities of 83.3%,87.5%,82.6%,83.3%,86.7%,and 92.1%,respectively.CONCLUSION The social function scores of patients with residual symptoms of depression are high.They are affected by disease history,medication compliance,therapy method,degree of somatic symptoms,residual symptoms,and anxiety.展开更多
Water use efficiency(WUE),as a pivotal indicator of the coupling degree within the carbon–water cycle of ecosystems,holds considerable importance in assessment of the carbon–water balance within terrestrial ecosyste...Water use efficiency(WUE),as a pivotal indicator of the coupling degree within the carbon–water cycle of ecosystems,holds considerable importance in assessment of the carbon–water balance within terrestrial ecosystems.However,in the context of global warming,WUE evolution and its primary drivers on the Tibetan Plateau remain unclear.This study employed the ensemble empirical mode decomposition method and the random forest algorithm to decipher the nonlinear trends and drivers of WUE on the Tibetan Plateau in 2001–2020.Results indicated an annual mean WUE of 0.8088 gC/mm·m^(2)across the plateau,with a spatial gradient reflecting decrease from the southeast toward the northwest.Areas manifesting monotonous trends of increase or decrease in WUE accounted for 23.64%and 9.69%of the total,respectively.Remarkably,66.67%of the region exhibited trend reversals,i.e.,39.94%of the area of the Tibetan Plateau showed transition from a trend of increase to a trend of decrease,and 26.73%of the area demonstrated a shift from a trend of decrease to a trend of increase.Environmental factors accounted for 70.79%of the variability in WUE.The leaf area index and temperature served as the major driving forces of WUE variation.展开更多
Recrystallization stands as an essential process that influences the microstructure and properties of magnesium(Mg)alloys,yet its mechanisms remain complex and multifaceted.This review explores the key factors affecti...Recrystallization stands as an essential process that influences the microstructure and properties of magnesium(Mg)alloys,yet its mechanisms remain complex and multifaceted.This review explores the key factors affecting the recrystallization behavior of Mg alloys,emphasizing how their unique structural characteristics impact the driving forces and dynamics of recrystallization.Unlike conventional alloys,Mg alloys exhibit distinctive recrystallization kinetics,which is significantly affected by deformation conditions,such as strain rate,temperature,and processing methods(e.g.,rolling,forging,and extrusion).The process is also influenced by material characteristics,including initial grain size,texture,dislocation density,solute clustering,and stacking fault energy.Additionally,uneven strain distribution,stress concentrations,and stored energy play crucial roles in shaping the formation of recrystallized grains,particularly near grain boundaries.Notably,recrystallization is driven by dislocation accumulation and the availability of slip systems,with new strain-free grains typically forming in regions of high dislocation density.This paper synthesizes the existing literature to provide a comprehensive understanding of the mechanisms and kinetics of recrystallization in Mg alloys,highlighting the influence of microstructural features such as second-phase particles and grain boundary characteristics.It also identifies key challenges and suggests promising directions for future research,including optimizing material compositions and the interaction between deformation conditions via machine learning.展开更多
BACKGROUND Newborns are immediately admitted to the neonatal intensive care unit(NICU)after birth,and thus mothers suffer from the pain of mother-infant separation.Some mothers worry about alterations in their child’...BACKGROUND Newborns are immediately admitted to the neonatal intensive care unit(NICU)after birth,and thus mothers suffer from the pain of mother-infant separation.Some mothers worry about alterations in their child’s condition and the uncertainty and high medical costs of possible sequelae,which frequently cause anxiety,depression,and other adverse emotions.AIM To investigate the anxiety and depression status of mothers of children in the NICU and its related factors.METHODS A convenient sampling method is adopted.The research objects included the mothers of 191 children in the NICU of Suzhou Ninth Hospital Affiliated with Suzhou University from January 2023 to July 2024.The general information questionnaire,personal control scale,self-rating anxiety scale,and self-rating depression scale were utilized for investigation.Anxiety and depression status in mothers of children in the NICU and its related factors were analyzed.RESULTS The incidences of maternal anxiety and depression among 191 hospitalized children in the NICU were 32.98%(63/191)and 23.56%(45/191),respectively.Single-factor analysis reveals that family monthly income,individual sense of control,gestational age of the child,and the number of diseases in the child are associated with the anxiety and depression experienced by the mother of the child in the NICU(P<0.05).Multivariate logistic regression analysis revealed that family monthly income of<5000 yuan(RMB),poor individual control,gestational age of<32 weeks,and the number of diseases of≥3 kinds are all related factors for anxiety and depression in mothers of children admitted to the NICU(P<0.05).CONCLUSION Mothers of children admitted to the NICU demonstrated high anxiety and depression incidences.The nursing staff in the neonatal department established intervention measures for each related factor,strengthened communication and communication with the mother of the child,and did a good job in psychological counseling.展开更多
BACKGROUND China has recently encountered severe challenges associated with population aging.Parents of first-generation only children face significant challenges regarding elderly care needs and the associated negati...BACKGROUND China has recently encountered severe challenges associated with population aging.Parents of first-generation only children face significant challenges regarding elderly care needs and the associated negative emotions.AIM To analyze the elderly care needs of first-generation only child parents in China and identify factors that influence negative emotions.METHODS This study used a cross-sectional design.Convenience sampling was used to select 1580 elderly individuals who met the inclusion criteria in a Chinese city between June and September 2022.A questionnaire was administered to collect general information about participants.Depression and anxiety were assessed using the patient health questionnaire-9 and generalized anxiety disorder-7 scale,respectively.A logistic regression analysis was performed to evaluate the relevant correlations.RESULTS Among 1580 first-generation only child parents,1120(70.89%)preferred family based care,324(20.51%)opted for community care,and 136(8.61%)chose institutional care,with 460(29.11%)reporting negative emotions.Significant differences in the distribution of negative emotions among only child parents were observed based on age,marital status,living conditions,disability,type of chronic disease,frailty status,and family support(P<0.05).The regression analysis indicated that disability,type of chronic disease,living environment,frailty status,and level of family support were independent risk factors for negative emotions among parents with only children(P<0.05).CONCLUSION Elderly care for parents of only children is primarily family-based.Independent risk factors for negative emotions in this group include disability,chronic disease type,and living environment.展开更多
BACKGROUND The development of hepatocellular carcinoma(HCC)is influenced by multiple factors.Interventional therapy offers an effective treatment option for patients with unresectable intermediate-to-advanced HCC.Inte...BACKGROUND The development of hepatocellular carcinoma(HCC)is influenced by multiple factors.Interventional therapy offers an effective treatment option for patients with unresectable intermediate-to-advanced HCC.Interventional therapy can induce electrocardiographic(ECG)abnormalities that may be associated with liver dysfunction,electrolyte disorders,and cardiac injury.AIM To explore the ECG alterations and determinants following interventional therapy in patients with HCC.METHODS Sixty patients undergoing interventional treatment for liver cancer were selected as study participants.According to the results of the dynamic ECG examination 1 day after surgery,the patients were divided into an abnormal group(n=21)and a nonabnormal group(n=39).With the help of dynamic ECG examination,the ECG parameters were compared and the baseline data of patients was recorded in the two groups.RESULTS The 24 hours QT interval variability,24 hours normal atrial polarization to ventricular polarization(R-R)interval(standard deviation),24 hours consecutive 5 minutes normal R-R interval,and 24 hours continuous 5 minutes normal R-R interval(standard deviation mean)were lower than patients in the nonabnormal group(P<0.05).The logistic analysis showed that age>60 years,liver function grade B,and postoperative body temperature 38°C were risk factors for abnormal dynamic electrocardiogram in patients with liver cancer intervention(P<0.05).CONCLUSION Interventional therapy for HCC can lead to ECG abnormalities,underscoring the clinical need for enhanced cardiac monitoring to mitigate myocardial complications.展开更多
BACKGROUND Patients with middle and advanced hepatocellular carcinoma(HCC)frequently experience significant anxiety and depression,severely affecting their quality of life.AIM To examine the anxiety and depression sta...BACKGROUND Patients with middle and advanced hepatocellular carcinoma(HCC)frequently experience significant anxiety and depression,severely affecting their quality of life.AIM To examine the anxiety and depression status of patients with middle and advanced HCC,the influencing factors,and the correlation between these psychological factors and quality of life.METHODS We collected baseline data from 100 patients with HCC,assessing anxiety and depression levels using the Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD).Quality of life was evaluated with the Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire.Multivariate logistic regression analyzed clinical and psychosocial factors affecting anxiety and depression,while Pearson correlation assessed relationships among HAMA,HAMD,and Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire scores.RESULTS Results indicated that 64%of patients exhibited anxiety and 65%showed depression symptoms.Key influencing factors included Barcelona Clinic Liver Cancer C stage,multiple tumors,social support,prior treatments(such as liver resection and transcatheter arterial chemoembolization/hepatic artery infusion chemotherapy),as well as HAMA and HAMD scores.Anxiety and depression correlated negatively with quality of life,with coefficients of-0.671 and-0.575 for HAMA and HAMD,respectively.CONCLUSION Anxiety and depression are prevalent among patients with middle and advanced HCC,impacting quality of life.This underscores the need for psychological health considerations in liver cancer treatment and establishing psychological interventions is essential.展开更多
This paper thoroughly explores the multifaceted factors influencing the efficacy of Chinese medicinals and categorizes them into three main groups:medicinal related factors,patient related factors,and practitioner rel...This paper thoroughly explores the multifaceted factors influencing the efficacy of Chinese medicinals and categorizes them into three main groups:medicinal related factors,patient related factors,and practitioner related factors.Regarding medicinal related factors,the place of origin,growing environment,harvesting time,storage conditions,quality control,dosage form selection,compatibility of medicinals,precise dosing,decoction methods,and administration routes all significantly impact efficacy.The place of origin determines the authenticity of medicinals,the growing environment affects their composition,harvesting time influences potency,improper storage leads to deterioration,quality control forms the foundation of efficacy,dosage forms and compatibility of medicinals affect absorption,dosing and decoction methods require precision,and administration routes should be tailored to individuals.Patient related factors include psychological state,individual differences,background,and disease condition.Psychological state affects treatment compliance,individual differences determine medicine responses,background influences patients’understanding of Chinese medicinals,and disease condition directly reflects efficacy.Practitioner related factors encompass theoretical knowledge,clinical experience,inherited practices,psychological state,and professional ethics.Theoretical knowledge guides medication use,clinical experience enhances efficacy,inherited practices influence prescribing styles,psychological state affects doctor–patient communication,and professional ethics ensure medical quality.These interrelated factors collectively influence the efficacy of Chinese medicinals,emphasizing the need for comprehensive consideration in clinical applications to achieve optimal therapeutic outcomes.展开更多
BACKGROUND Identifying factors that influence non-curative resection(NCR)is critical to optimize treatment strategies and improve patient outcomes in patients with early gastric cancer(EGC).AIM To investigate the fact...BACKGROUND Identifying factors that influence non-curative resection(NCR)is critical to optimize treatment strategies and improve patient outcomes in patients with early gastric cancer(EGC).AIM To investigate the factors influencing the NCR of EGC and to evaluate the predictive value of these factors.METHODS The clinical data of 173 patients with EGC admitted between July 2020 and July 2023 were retrospectively collected.According to radical resection criteria,the patients were further divided into curative resection group(n=143)and NCR group(n=30).Clinical information was collected,including surgical method,tumor diameter,tumor site,ulcer formation,depth of invasion,pathological type,and lymph node metastasis.Logistic regression analysis was used to explore the factors affecting non-curable resection.RESULTS Multivariate logistic regression analysis showed that ulcer formation[odds ratio(OR)=3.53;95%confidence interval(CI):1.55-8.01,P=0.003],pathological type(OR=3.73;95%CI:1.60-8.74,P=0.002),tumor diameter(OR=3.15;95%CI:1.40-7.05,P=0.005),tumor location(OR=3.50;95%CI:1.16-10.58,P=0.027),lymph node metastasis(OR=4.40;95%CI:1.83-10.57,P=0.001),and depth of penetration(OR=3.75;95%CI:1.60-8.74,P=0.002)were all risk factors for NCR in EGC patients.Predictive analysis showed varying area under the curve values for factors such as tumor diameter(0.636),tumor location(0.608),ulcer formation(0.652),infiltration depth(0.658),pathological type(0.656),and lymph node metastasis(0.674).CONCLUSION The results suggest that factors such as tumor diameter,tumor location,ulcer formation,depth of invasion,pathological type,and lymph node metastasis increase the risk of NCR in EGC patients.展开更多
Objective Accurately identifying the key influencing factors of psychological birth trauma in primiparous women is crucial for implementing effective preventive and intervention measures.This study aimed to develop an...Objective Accurately identifying the key influencing factors of psychological birth trauma in primiparous women is crucial for implementing effective preventive and intervention measures.This study aimed to develop and validate an interpretable machine learning prediction model for identifying the key influencing factors of psychological birth trauma in primiparous women.Methods A multicenter cross-sectional study was conducted on primiparous women in four tertiary hospitals in Sichuan Province,southwestern China,from December 2023 to March 2024.The Childbirth Trauma Index was used in assessing psychological birth trauma in primiparous women.Data were collected and randomly divided into a training set(80%,n=289)and a testing set(20%,n=73).Six different machine learning models were trained and tested.Training and prediction were conducted using six machine learning models included Linear Regression,Support Vector Regression,Multilayer Perceptron Regression,eXtreme Gradient Boosting Regression,Random Forest Regression,and Adaptive Boosting Regression.The optimal model was selected based on various performance metrics,and its predictive results were interpreted using SHapley Additive exPlanations(SHAP)and accumulated local effects(ALE).Results Among the six machine learning models,the Multilayer Perceptron Regression model exhibited the best overall performance in the testing set(MAE=3.977,MSE=24.832,R2=0.507,EVS=0.524,RMSE=4.983).In the testing set,the R2 and EVS of the Multilayer Perceptron Regression model increased by 8.3%and 1.2%,respectively,compared to the traditional linear regression model.Meanwhile,the MAE,MSE,and RMSE decreased by 0.4%,7.3%,and 3.7%,respectively,compared to the traditional linear regression model.The SHAP analysis indicated that intrapartum pain,anxiety,postpartum pain,resilience,and planned pregnancy are the most critical influencing factors of psychological birth trauma in primiparous women.The ALE analysis indicated that higher intrapartum pain,anxiety,and postpartum pain scores are risk factors,while higher resilience scores are protective factors.Conclusions Interpretable machine learning prediction models can identify the key influencing factors of psychological birth trauma in primiparous women.SHAP and ALE analyses based on the Multilayer Perceptron Regression model can help healthcare providers understand the complex decision-making logic within a prediction model.This study provides a scientific basis for the early prevention and personalized intervention of psychological birth trauma in primiparous women.展开更多
Cross-border e-commerce,as a new form of international trade,has shown great development potential in the context of the“Belt and Road”initiative.Based on the cross-border e-commerce export data from 2015 to 2024,th...Cross-border e-commerce,as a new form of international trade,has shown great development potential in the context of the“Belt and Road”initiative.Based on the cross-border e-commerce export data from 2015 to 2024,this paper analyzes the influencing factors of China's cross-border e-commerce exports to countries along the“Belt and Road”by constructing an econometric model.The study found that factors such as the perfection of digital infrastructure,the efficiency of logistics and transportation,the convenience of payment and settlement,and the penetration rate of consumers online shopping significantly affect the export scale of cross-border e-commerce.Institutional factors such as the development level of e-commerce platforms in countries along the route,market access thresholds,and tariff policies also play an important role.Based on the research results,suggestions are put forward to strengthen the construction of cross-border payment system,optimize the logistics distribution network,promote customs clearance facilitation,and deepen cooperation in the field of e-commerce,to provide references for promoting the development of China's crossborder e-commerce exports to countries along the“Belt and Road.”展开更多
文摘Extending the retirement age is an inevitable trend with the extension of the life expectancy of the population, reducing the financial burden of pensions, increasing the utilization rate of human capital, alleviating the shortage of the labor market and other social problems. More and more countries are beginning to impose extended retirement policies, like United States, South Korea, Canada and Nordic countries and so on, all have taken some measures to delay retirement. However, the general social recognition is not high. Both the aged group, the education level and the individual＇s lifestyle have a significant impact on the delayed retirement age policy. Severe aging situation puts the future pension system at risk, based on the interests of the country, delayed retirement will help utilize the human capital and relieve the country＇ s financial pressure; from individual perspective, extending retirement age can help reduce the provision for the aged people. This article based on previous literatures review, through conducted the survey of people in Halmstad to analyze the local citizen＇s perception on delayed retirement and the influencing factors behind. Concluded that willingness of delayed retirement among people is not very high, reasons vary from different kinds of people.
文摘Background There is little information on the factors that have influenced the long-term success rate of radiofrequency ablation of ventricular arrhythmias(VAs)at different targets.The objective of this study was to investigate the characteristics of the ablation of VAs and the factors influencing the long-term success rate in our center.Methods Totally,2751 consecutive patients(mean ages 44±15 years,male/female 58.6%/41.4%)with VAs underwent radiofrequency ablation in Guangdong Provincial People’s Hospital from 2013 to 2018 were analyzed.Baseline data were retrieved from the medical record system.Long-term follow-up data were obtained by telephone interview.We mainly recorded the patient’s last post-ablation holter,and the symptoms after ablation.Multivariable regressions were applied to assess the relationship between the long-term success rate and the influence factors.Results Through the baseline data of 2751 patients,we found that the acute success rate of ablation was 95.1%.The average follow-up time was 16±5 months(ranging from 1 to 80).In all,304 patients(11%)lost follow-up,while 2447 patients(89%)were successfully followed.The long-term success rate of ablation was 82.56%.By means of multivariable regression analyses,it was discovered that cardiovascular diseases,such as coronary heart disease(OR:0.568,95%CI:0.327-0.987),hypertension(OR:1.554,95%CI:1.100-2.198),were independently associated with the long-term success rate,as well as ablation approaches(OR:0.212,95%CI:0.082-0.550).Lower ablation success rates of the patients whose VAs were originated from some uncommon region,like left ventricular papillary muscle,Summit,etc.were observed.Conclusions Ablation approaches,concomitant cardiovascular diseases,and ablation targets were related to the long-term clinical outcome of VAs ablation.
文摘This paper deals with the shape and influenced factors of surface non-continuous deformation due to mining. With finite element method, analysis are made to derive the relations between discontinuous deformation and mining affection, weak plane’s position & thickness, and mechanical property of weak-plane medium. The mutual affection of multiple weak-planes is also discussed. The results of the paper lay a foundation for constructing the calculation method of surface discontinuous deformation.
基金supported by the National Natural Science Foundation of China(82574173,82003516)Jiangsu Provincial Natural Science Foundation(BK20251958)+2 种基金Jiangsu Provincial Medical Key Discipline(ZDXK202250)Top Talent Awards Project Fund(RDF-TP-0023,RDF-TP-0030)Postgraduate Research Fund(PGRS2112022)at Xi'an Jiaotong-Liverpool University.
文摘Tuberculosis(TB),one of the oldest infectious diseases caused by Mycobacterium tuberculosis,poses a considerable challenge to global public health.There are approximately 10 million new TB cases worldwide annually,and TB claims the lives of nearly 3 million people each year,making it one of the leading causes of death from a single infectious disease[1].China ranks third globally in terms of TB burden,with approximately 733,000 TB cases reported in 2023[2].Based on the ecological model of health determinants developed by Whitehead and Dahlgren,health determinants can be classified into direct causes.
基金supported by the Natural Science Foundation of China(No.52470105)the Young Taishan Scholars Program of Shandong Province(No.358202103017).
文摘The discharge of micro-polluted water from sources such as agricultural runoff,urban stormwater,and treated effluents presents significant challenges to aquatic ecosystems.Constructed wetlands(CWs)have gained recog-nition as an eco-friendly solution for removing pollutants from various wastewater sources and are increasingly applied for micro-polluted water treatment.By reviewing 78 full-scale CW studies from Web of Science,it is summarized that the ranges of ammonium nitrogen(NH4+-N)concentrations in runoff,wastewater treatment plant effluent and polluted river were 0.1–6.6,0.3–12.3,and 0.2–41.1 mg/L,respectively.The ranges of ni-trate nitrogen concentrations were 0.2–14.2,0–5.7,and 0–2.6 mg/L,respectively.Removal efficiencies of CWs for micro-polluted water varied by CW types.The total nitrogen removal efficiencies for subsurface-flow CWs,free-water surface-flow CWs,and hybrid CWs ranged from 27.4%to 66.5%,16.8%to 89.8%,and 19.4%to 88.2%,respectively.The NH4+-N removal efficiencies ranged from 34.2%to 73.6%,38.4%to 89.4%and 13.5%to 94.2%,respectively.Additionally,other factors influencing contaminant removal efficiency such as hydraulic retention time,vegetation types,redox micro-environment and influent water quality were evaluated.Based on these findings,two strategies for improving the purification performance of CWs were proposed:the selection of incorporating electron donor substrates and the optimization of operation parameters.This paper serves as a synthesis of information to guide future research and full-scale CW applications in micro-polluted water treatment.
基金Supported by Open Fund Project of the Engineering Technology Research Center of Characteristic Medicinal Plants of Fujian(PP202003).
文摘This paper provides a systematic review of the histochemical localization,content characteristics,and influencing factors of saponins in Pseudostellaria heterophylla based on an extensive literature survey.It provides an in-depth analysis and summary of the effects of biological factors,environmental conditions,agronomic practices,processing methods,and continuous cropping obstacles on the synthesis of P.heterophylla saponins,as well as their underlying mechanisms.Based on identified gaps in the current literature,future research directions and prospects are proposed.The findings of this review offer valuable insights for advancing the understanding of the saponin biosynthesis mechanisms in P.heterophylla and for enhancing its quality.
基金China Health and Retirement Longitudinal Study(CHARLS)the 2022-2023 Nursing Research Project of Chinese Medical Association Publishing House(Grant No.CMAPH-NRD2022024)。
文摘Background:The trajectory of intrinsic capacity(IC)among the older population is characterized by its diversity and is predictive of adverse health outcomes such as disability,nursing home admission,decline in quality of life,and mortality.Gaining an understanding of the trajectory of IC and the factors that influence it is of paramount importance for fostering healthy aging.This research is focused on exploring the trajectory of IC among older adults in China and examining the factors that influence it.Methods:This observational longitudinal cohort study leveraged data from the China Health and Retirement Longitudinal Study(CHARLS),which was conducted in the years 2011,2013,and 2015.For the purpose of this analysis,a total of 2,233 participants who were aged 60 and over were included.A Growth Mixture Model(GMM)was utilized to define trajectory categories for IC.Influential factors were ascertained based on the health ecology model,and binary logistic regression analysis was utilized to investigate the factors linked with the different trajectory categories.Results:Two distinct trajectory classes of IC were identified:Class 1,the normal-stable group,encompassed 90.4%of the elderly population,while Class 2,the declining group,made up 9.6%.Advanced age and a history of stroke were found to be significantly associated with Class 2.High scores in activities of daily living(ADL),employment status,receiving primary or junior high school education,and residence in the East or Central regions of China were significantly linked with Class 1.Conclusion:The trajectory of IC among older Chinese adults is marked by its heterogeneity.Advanced age and a history of stroke are significant risk factors for a declining IC trajectory,while higher ADL scores,being employed,receiving primary or junior high school education,and residing in the East or Central regions of China are protective factors associated with a stable IC trajectory.Healthcare institutions must closely monitor IC levels and understand these trajectory patterns to implement personalized and targeted interventions promptly to maintain IC at a healthy level and advocate for healthy aging.
基金Supported by the Scientific Research Projects of the Health System in Pingshan District,No.2023122.
文摘BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery speed and quality of life.Effective prevention of anxiety and depression in elderly patients has become an urgent problem.AIM To investigate the trajectory of anxiety and depression levels in elderly patients after LIF,and the influencing factors.METHODS Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital.General information and surgery-related indices were recorded,and participants completed measures of psychological status,lumbar spine dysfunction,and quality of life.A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels,and unordered multi-categorical logistic regression was used to analyze the influencing factors.RESULTS Three trajectories of change in anxiety level were identified:Increasing anxiety(n=26,10.88%),decreasing anxiety(n=27,11.30%),and stable anxiety(n=186,77.82%).Likewise,three trajectories of change in depression level were identified:Increasing depression(n=30,12.55%),decreasing depression(n=26,10.88%),and stable depression(n=183,76.57%).Regression analysis showed that having no partner,female sex,elevated Oswestry dysfunction index(ODI)scores,and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels,whereas female sex,postoperative opioid use,and elevated ODI scores all contributed to increased depression levels.CONCLUSION During clinical observation,combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention,quickens recovery,and enhances quality of life.
基金Special Scientific Found for Seismic Industry Under Grant No.201008005
文摘Based on raw data from dams damaged in the Wenchuan earthquake, including many that were severely damaged, characteristics and factors that influenced the damage are discussed in this paper. Findings from this study include： severely damaged dams were densely distributed along the seismologic fault; small dams, especially small earth-rock dams, had the most serious damage that was caused by a variety of factors; the most serious damage was caused by seismic waves; damage was aggregated by aftershocks; and the extent of the damage patterns increased with the seismic intensity. Damage patterns varied in different intensity zones and cracking was the most common type of damage. Most of the dams had a good base with relatively high bearing capacity, and the walls of the earth-rock dams were mostly of clay soil. This type of base and body material mitigated some of the damage to dams. Reservoir maintenance and other factors also have a significant impact on the seismic safety of the dam. Finally, some recommendations to reduce seismic damage to dams are proposed.
文摘BACKGROUND At present,the influencing factors of social function in patients with residual depressive symptoms are still unclear.Residual depressive symptoms are highly harmful,leading to low mood in patients,affecting work and interpersonal communication,increasing the risk of recurrence,and adding to the burden on families.Studying the influencing factors of their social function is of great significance.AIM To explore the social function score and its influencing factors in patients with residual depressive symptoms.METHODS This observational study surveyed patients with residual depressive symptoms(case group)and healthy patients undergoing physical examinations(control group).Participants were admitted between January 2022 and December 2023.Social functioning was assessed using the Sheehan Disability Scale(SDS),and scores were compared between groups.Factors influencing SDS scores in patients with residual depressive symptoms were analyzed by applying multiple linear regression while using the receiver operating characteristic curve,and these RESULTS The SDS scores of the 158 patients with depressive symptoms were 11.48±3.26.Compared with the control group,the SDS scores and all items in the case group were higher.SDS scores were higher in patients with relapse,discon-tinuous medication,drug therapy alone,severe somatic symptoms,obvious residual symptoms,and anxiety scores≥8.Disease history,medication compliance,therapy method,and residual symptoms correlated positively with SDS scores(r=0.354,0.414,0.602,and 0.456,respectively).Independent influencing factors included disease history,medication compliance,therapy method,somatic symptoms,residual symptoms,and anxiety scores(P<0.05).The areas under the curve for predicting social functional impairment using these factors were 0.713,0.559,0.684,0.729,0.668,and 0.628,respectively,with sensitivities of 79.2%,61.8%,76.8%,81.7%,63.6%,and 65.5%and specificities of 83.3%,87.5%,82.6%,83.3%,86.7%,and 92.1%,respectively.CONCLUSION The social function scores of patients with residual symptoms of depression are high.They are affected by disease history,medication compliance,therapy method,degree of somatic symptoms,residual symptoms,and anxiety.
基金National Nonprofit Institute Research Grant of CAF,No.CAFYBB2018ZA004,No.CAFYBB2023ZA009Fengyun Application Pioneering Project,No.FY-APP-ZX-2023.02。
文摘Water use efficiency(WUE),as a pivotal indicator of the coupling degree within the carbon–water cycle of ecosystems,holds considerable importance in assessment of the carbon–water balance within terrestrial ecosystems.However,in the context of global warming,WUE evolution and its primary drivers on the Tibetan Plateau remain unclear.This study employed the ensemble empirical mode decomposition method and the random forest algorithm to decipher the nonlinear trends and drivers of WUE on the Tibetan Plateau in 2001–2020.Results indicated an annual mean WUE of 0.8088 gC/mm·m^(2)across the plateau,with a spatial gradient reflecting decrease from the southeast toward the northwest.Areas manifesting monotonous trends of increase or decrease in WUE accounted for 23.64%and 9.69%of the total,respectively.Remarkably,66.67%of the region exhibited trend reversals,i.e.,39.94%of the area of the Tibetan Plateau showed transition from a trend of increase to a trend of decrease,and 26.73%of the area demonstrated a shift from a trend of decrease to a trend of increase.Environmental factors accounted for 70.79%of the variability in WUE.The leaf area index and temperature served as the major driving forces of WUE variation.
基金funding by the National Natural Science Foundation of China(Grant number U22A20187)(Grant No.52271147,No.52471175)China Postdoctoral Science Foundation(grant number 2024M751172)。
文摘Recrystallization stands as an essential process that influences the microstructure and properties of magnesium(Mg)alloys,yet its mechanisms remain complex and multifaceted.This review explores the key factors affecting the recrystallization behavior of Mg alloys,emphasizing how their unique structural characteristics impact the driving forces and dynamics of recrystallization.Unlike conventional alloys,Mg alloys exhibit distinctive recrystallization kinetics,which is significantly affected by deformation conditions,such as strain rate,temperature,and processing methods(e.g.,rolling,forging,and extrusion).The process is also influenced by material characteristics,including initial grain size,texture,dislocation density,solute clustering,and stacking fault energy.Additionally,uneven strain distribution,stress concentrations,and stored energy play crucial roles in shaping the formation of recrystallized grains,particularly near grain boundaries.Notably,recrystallization is driven by dislocation accumulation and the availability of slip systems,with new strain-free grains typically forming in regions of high dislocation density.This paper synthesizes the existing literature to provide a comprehensive understanding of the mechanisms and kinetics of recrystallization in Mg alloys,highlighting the influence of microstructural features such as second-phase particles and grain boundary characteristics.It also identifies key challenges and suggests promising directions for future research,including optimizing material compositions and the interaction between deformation conditions via machine learning.
文摘BACKGROUND Newborns are immediately admitted to the neonatal intensive care unit(NICU)after birth,and thus mothers suffer from the pain of mother-infant separation.Some mothers worry about alterations in their child’s condition and the uncertainty and high medical costs of possible sequelae,which frequently cause anxiety,depression,and other adverse emotions.AIM To investigate the anxiety and depression status of mothers of children in the NICU and its related factors.METHODS A convenient sampling method is adopted.The research objects included the mothers of 191 children in the NICU of Suzhou Ninth Hospital Affiliated with Suzhou University from January 2023 to July 2024.The general information questionnaire,personal control scale,self-rating anxiety scale,and self-rating depression scale were utilized for investigation.Anxiety and depression status in mothers of children in the NICU and its related factors were analyzed.RESULTS The incidences of maternal anxiety and depression among 191 hospitalized children in the NICU were 32.98%(63/191)and 23.56%(45/191),respectively.Single-factor analysis reveals that family monthly income,individual sense of control,gestational age of the child,and the number of diseases in the child are associated with the anxiety and depression experienced by the mother of the child in the NICU(P<0.05).Multivariate logistic regression analysis revealed that family monthly income of<5000 yuan(RMB),poor individual control,gestational age of<32 weeks,and the number of diseases of≥3 kinds are all related factors for anxiety and depression in mothers of children admitted to the NICU(P<0.05).CONCLUSION Mothers of children admitted to the NICU demonstrated high anxiety and depression incidences.The nursing staff in the neonatal department established intervention measures for each related factor,strengthened communication and communication with the mother of the child,and did a good job in psychological counseling.
基金Supported by General Projects of Henan Province Universities Humanities and Social Sciences Research in 2023,No.2023-ZDJH-533.
文摘BACKGROUND China has recently encountered severe challenges associated with population aging.Parents of first-generation only children face significant challenges regarding elderly care needs and the associated negative emotions.AIM To analyze the elderly care needs of first-generation only child parents in China and identify factors that influence negative emotions.METHODS This study used a cross-sectional design.Convenience sampling was used to select 1580 elderly individuals who met the inclusion criteria in a Chinese city between June and September 2022.A questionnaire was administered to collect general information about participants.Depression and anxiety were assessed using the patient health questionnaire-9 and generalized anxiety disorder-7 scale,respectively.A logistic regression analysis was performed to evaluate the relevant correlations.RESULTS Among 1580 first-generation only child parents,1120(70.89%)preferred family based care,324(20.51%)opted for community care,and 136(8.61%)chose institutional care,with 460(29.11%)reporting negative emotions.Significant differences in the distribution of negative emotions among only child parents were observed based on age,marital status,living conditions,disability,type of chronic disease,frailty status,and family support(P<0.05).The regression analysis indicated that disability,type of chronic disease,living environment,frailty status,and level of family support were independent risk factors for negative emotions among parents with only children(P<0.05).CONCLUSION Elderly care for parents of only children is primarily family-based.Independent risk factors for negative emotions in this group include disability,chronic disease type,and living environment.
文摘BACKGROUND The development of hepatocellular carcinoma(HCC)is influenced by multiple factors.Interventional therapy offers an effective treatment option for patients with unresectable intermediate-to-advanced HCC.Interventional therapy can induce electrocardiographic(ECG)abnormalities that may be associated with liver dysfunction,electrolyte disorders,and cardiac injury.AIM To explore the ECG alterations and determinants following interventional therapy in patients with HCC.METHODS Sixty patients undergoing interventional treatment for liver cancer were selected as study participants.According to the results of the dynamic ECG examination 1 day after surgery,the patients were divided into an abnormal group(n=21)and a nonabnormal group(n=39).With the help of dynamic ECG examination,the ECG parameters were compared and the baseline data of patients was recorded in the two groups.RESULTS The 24 hours QT interval variability,24 hours normal atrial polarization to ventricular polarization(R-R)interval(standard deviation),24 hours consecutive 5 minutes normal R-R interval,and 24 hours continuous 5 minutes normal R-R interval(standard deviation mean)were lower than patients in the nonabnormal group(P<0.05).The logistic analysis showed that age>60 years,liver function grade B,and postoperative body temperature 38°C were risk factors for abnormal dynamic electrocardiogram in patients with liver cancer intervention(P<0.05).CONCLUSION Interventional therapy for HCC can lead to ECG abnormalities,underscoring the clinical need for enhanced cardiac monitoring to mitigate myocardial complications.
文摘BACKGROUND Patients with middle and advanced hepatocellular carcinoma(HCC)frequently experience significant anxiety and depression,severely affecting their quality of life.AIM To examine the anxiety and depression status of patients with middle and advanced HCC,the influencing factors,and the correlation between these psychological factors and quality of life.METHODS We collected baseline data from 100 patients with HCC,assessing anxiety and depression levels using the Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD).Quality of life was evaluated with the Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire.Multivariate logistic regression analyzed clinical and psychosocial factors affecting anxiety and depression,while Pearson correlation assessed relationships among HAMA,HAMD,and Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire scores.RESULTS Results indicated that 64%of patients exhibited anxiety and 65%showed depression symptoms.Key influencing factors included Barcelona Clinic Liver Cancer C stage,multiple tumors,social support,prior treatments(such as liver resection and transcatheter arterial chemoembolization/hepatic artery infusion chemotherapy),as well as HAMA and HAMD scores.Anxiety and depression correlated negatively with quality of life,with coefficients of-0.671 and-0.575 for HAMA and HAMD,respectively.CONCLUSION Anxiety and depression are prevalent among patients with middle and advanced HCC,impacting quality of life.This underscores the need for psychological health considerations in liver cancer treatment and establishing psychological interventions is essential.
文摘This paper thoroughly explores the multifaceted factors influencing the efficacy of Chinese medicinals and categorizes them into three main groups:medicinal related factors,patient related factors,and practitioner related factors.Regarding medicinal related factors,the place of origin,growing environment,harvesting time,storage conditions,quality control,dosage form selection,compatibility of medicinals,precise dosing,decoction methods,and administration routes all significantly impact efficacy.The place of origin determines the authenticity of medicinals,the growing environment affects their composition,harvesting time influences potency,improper storage leads to deterioration,quality control forms the foundation of efficacy,dosage forms and compatibility of medicinals affect absorption,dosing and decoction methods require precision,and administration routes should be tailored to individuals.Patient related factors include psychological state,individual differences,background,and disease condition.Psychological state affects treatment compliance,individual differences determine medicine responses,background influences patients’understanding of Chinese medicinals,and disease condition directly reflects efficacy.Practitioner related factors encompass theoretical knowledge,clinical experience,inherited practices,psychological state,and professional ethics.Theoretical knowledge guides medication use,clinical experience enhances efficacy,inherited practices influence prescribing styles,psychological state affects doctor–patient communication,and professional ethics ensure medical quality.These interrelated factors collectively influence the efficacy of Chinese medicinals,emphasizing the need for comprehensive consideration in clinical applications to achieve optimal therapeutic outcomes.
文摘BACKGROUND Identifying factors that influence non-curative resection(NCR)is critical to optimize treatment strategies and improve patient outcomes in patients with early gastric cancer(EGC).AIM To investigate the factors influencing the NCR of EGC and to evaluate the predictive value of these factors.METHODS The clinical data of 173 patients with EGC admitted between July 2020 and July 2023 were retrospectively collected.According to radical resection criteria,the patients were further divided into curative resection group(n=143)and NCR group(n=30).Clinical information was collected,including surgical method,tumor diameter,tumor site,ulcer formation,depth of invasion,pathological type,and lymph node metastasis.Logistic regression analysis was used to explore the factors affecting non-curable resection.RESULTS Multivariate logistic regression analysis showed that ulcer formation[odds ratio(OR)=3.53;95%confidence interval(CI):1.55-8.01,P=0.003],pathological type(OR=3.73;95%CI:1.60-8.74,P=0.002),tumor diameter(OR=3.15;95%CI:1.40-7.05,P=0.005),tumor location(OR=3.50;95%CI:1.16-10.58,P=0.027),lymph node metastasis(OR=4.40;95%CI:1.83-10.57,P=0.001),and depth of penetration(OR=3.75;95%CI:1.60-8.74,P=0.002)were all risk factors for NCR in EGC patients.Predictive analysis showed varying area under the curve values for factors such as tumor diameter(0.636),tumor location(0.608),ulcer formation(0.652),infiltration depth(0.658),pathological type(0.656),and lymph node metastasis(0.674).CONCLUSION The results suggest that factors such as tumor diameter,tumor location,ulcer formation,depth of invasion,pathological type,and lymph node metastasis increase the risk of NCR in EGC patients.
基金supported by the Sichuan Province Nursing Scientific Research Project Plan(H23022)the 2022 Municipal-University Science and Technology Strategic Cooperation Special Fund of Nanchong Science and Technology Bureau(22SXQT0222)。
文摘Objective Accurately identifying the key influencing factors of psychological birth trauma in primiparous women is crucial for implementing effective preventive and intervention measures.This study aimed to develop and validate an interpretable machine learning prediction model for identifying the key influencing factors of psychological birth trauma in primiparous women.Methods A multicenter cross-sectional study was conducted on primiparous women in four tertiary hospitals in Sichuan Province,southwestern China,from December 2023 to March 2024.The Childbirth Trauma Index was used in assessing psychological birth trauma in primiparous women.Data were collected and randomly divided into a training set(80%,n=289)and a testing set(20%,n=73).Six different machine learning models were trained and tested.Training and prediction were conducted using six machine learning models included Linear Regression,Support Vector Regression,Multilayer Perceptron Regression,eXtreme Gradient Boosting Regression,Random Forest Regression,and Adaptive Boosting Regression.The optimal model was selected based on various performance metrics,and its predictive results were interpreted using SHapley Additive exPlanations(SHAP)and accumulated local effects(ALE).Results Among the six machine learning models,the Multilayer Perceptron Regression model exhibited the best overall performance in the testing set(MAE=3.977,MSE=24.832,R2=0.507,EVS=0.524,RMSE=4.983).In the testing set,the R2 and EVS of the Multilayer Perceptron Regression model increased by 8.3%and 1.2%,respectively,compared to the traditional linear regression model.Meanwhile,the MAE,MSE,and RMSE decreased by 0.4%,7.3%,and 3.7%,respectively,compared to the traditional linear regression model.The SHAP analysis indicated that intrapartum pain,anxiety,postpartum pain,resilience,and planned pregnancy are the most critical influencing factors of psychological birth trauma in primiparous women.The ALE analysis indicated that higher intrapartum pain,anxiety,and postpartum pain scores are risk factors,while higher resilience scores are protective factors.Conclusions Interpretable machine learning prediction models can identify the key influencing factors of psychological birth trauma in primiparous women.SHAP and ALE analyses based on the Multilayer Perceptron Regression model can help healthcare providers understand the complex decision-making logic within a prediction model.This study provides a scientific basis for the early prevention and personalized intervention of psychological birth trauma in primiparous women.
文摘Cross-border e-commerce,as a new form of international trade,has shown great development potential in the context of the“Belt and Road”initiative.Based on the cross-border e-commerce export data from 2015 to 2024,this paper analyzes the influencing factors of China's cross-border e-commerce exports to countries along the“Belt and Road”by constructing an econometric model.The study found that factors such as the perfection of digital infrastructure,the efficiency of logistics and transportation,the convenience of payment and settlement,and the penetration rate of consumers online shopping significantly affect the export scale of cross-border e-commerce.Institutional factors such as the development level of e-commerce platforms in countries along the route,market access thresholds,and tariff policies also play an important role.Based on the research results,suggestions are put forward to strengthen the construction of cross-border payment system,optimize the logistics distribution network,promote customs clearance facilitation,and deepen cooperation in the field of e-commerce,to provide references for promoting the development of China's crossborder e-commerce exports to countries along the“Belt and Road.”
