BACKGROUND The coronavirus disease 2019 pandemic has had an ongoing impact on the public’s mental health that requires long-term attention.Exploring the relationship between mental health indicators would aid in iden...BACKGROUND The coronavirus disease 2019 pandemic has had an ongoing impact on the public’s mental health that requires long-term attention.Exploring the relationship between mental health indicators would aid in identifying solutions to improve public mental health.AIM To investigate the prevalence of anxiety,depression,and insomnia and explore the relationship among neuroticism,cognitive failures,and mental health.METHODS A cross-sectional survey was conducted in December 2023 using an online platform to recruit adult participants.The neuroticism,subjective cognitive function,and mental health of the participants were assessed using the neuroticism subscale of the Chinese Big Five Personality Inventory Brief Version,cognitive failures questionnaire,generalized anxiety disorder-7,patient health questionnaire-9,and insomnia severity index.Pearson's correlation analysis,independent samples t-tests,one-way analysis of variance,and structural equation model were used to examine the relationship between mental health indicators.RESULTS A total of 1011 valid questionnaires were collected,of which 343 were completed by male(33.93%)respondents and 668 were completed by female(66.07%)respondents.The rates of anxiety,depression,and insomnia were 41.3%,44.6%,and 36.3%,respectively,most cases of which were mild.Among the mental health indicators,there were significant differences by age and between those with siblings and those who were only children.Neuroticism and cognitive failures were significantly positively correlated with mental health indicators.Further moderated mediation analysis showed that cognitive failures mediated the relationship between insomnia and anxiety and between insomnia and depression,with neuroticism moderating the first half of this pathway and the effect being greater in the low-neuroticism group.CONCLUSION Cognitive failures and neuroticism play important roles in mental health.Therefore,enhancing subjective cognitive function and regulating emotional stability may contribute to the improvement of mental health.展开更多
The insertion and extraction of lithium ions in active materials lead to significant volumetric deformation,resulting in stresses that drive the mechanical degradation of these materials.This accumulation of mechanica...The insertion and extraction of lithium ions in active materials lead to significant volumetric deformation,resulting in stresses that drive the mechanical degradation of these materials.This accumulation of mechanical degradation ultimately leads to mechanical failure in lithium-ion batteries(LIB).This paper summarizes the experimental characterization techniques used to observe the mechanical degradation of lithium battery cells,electrodes,and particles across macro,micro,and nano scales.Additionally,the mechanical failure model for LIB that spans from the microscopic to the macroscopic scale has been outlined.Finally,we analyze the current challenges and opportunities,including the standardization of battery measurements,the quantification of mechanical failures,and the correlation between mechanical failures and electrochemical performance.展开更多
Compared to single-layer networks,multilayer networks exhibit a more complex node degree composition,comprising both intra-layer and inter-layer degrees.However,the distinct impacts of these degree types on cascading ...Compared to single-layer networks,multilayer networks exhibit a more complex node degree composition,comprising both intra-layer and inter-layer degrees.However,the distinct impacts of these degree types on cascading failures remain underexplored.Distinguishing their effects is crucial for a deeper understanding of network structure,information propagation,and behavior prediction.This paper proposes a capacity-load model to influence and compare the influence of different degree types on cascading failures in multilayer networks.By designing three node removal strategies based on total degree,intra-layer degree,and inter-layer degree,simulation experiments are conducted on four types of networks.Network robustness is evaluated using the maximum number of removable nodes before collapse.The relationships between network robustness and the coupling coefficient,as well as load and capacity adjustment parameters,are also analyzed.The results indicate that the node removal strategy with the least impact on cascading failures varies across different types of networks,revealing the significance of different node degrees in failure propagation.Compared to other models,the proposed model enables networks to maintain a higher maximum number of removable nodes during cascading failures,demonstrating superior robustness.展开更多
In wind and solar renewable-dominant hybrid alternating current/direct current(AC/DC)power systems,the active power of high-voltage direct current(HVDC)system is significantly limited by the security and stability eve...In wind and solar renewable-dominant hybrid alternating current/direct current(AC/DC)power systems,the active power of high-voltage direct current(HVDC)system is significantly limited by the security and stability events caused by cascading failures.To identify critical lines in cascading failures,a rapid risk assessment method is proposed based on the gradient boosting decision tree(GBDT)and frequent pat-tern growth(FP-Growth)algorithms.First,security and stability events triggered by cascading failures are analyzed to explain the impact of cascading failures on the maximum DC power.Then,a cascading failure risk index is defined,focusing on the DC power being limited.To handle the strong nonlinear relationship between the maximum DC power and cascading failures,a GBDT with an update strategy is utilized to rapidly predict the maximum DC power under uncertain operating conditions.Finally,the FP-Growth algorithm is improved to mine frequent patterns in cascading failures.The importance index for each fault in a frequent pattern is defined by evaluating its impact on cascading failures,enabling the identification of critical lines.Simulation results of a modified Ningxia–Shandong hybrid AC/DC system in China demonstrate that the proposed method can rapidly assess the risk of cascading failures and effectively identify critical lines.展开更多
This study explores ethical violations and audit failures in various large-scale corporate fraud cases.Using a qualitative descriptive method and based on secondary data from documented fraud cases and published audit...This study explores ethical violations and audit failures in various large-scale corporate fraud cases.Using a qualitative descriptive method and based on secondary data from documented fraud cases and published audit reports,the study applies the Fraud Triangle framework,focusing on how weak integrity,objectivity,and professional competence have undermined public trust in the auditing profession.Using a qualitative descriptive method and the Fraud Triangle framework,which includes pressure,opportunity,and rationalization,the study analyzes cases from Indonesia(SNP Finance,Jiwasraya),China(Evergrande),and Germany(Wirecard).The analysis reveals that many audit failures observed in this study appear to stem more from ethical challenges than from technical incapability,driven by client pressure,weak internal controls,and compromised auditor independence.These cases demonstrate a recurring global pattern in which auditors neglect their responsibility to act in the public interest.展开更多
This study explores ethical violations and audit failures in various large-scale corporate fraud cases.Using a qualitative descriptive method and based on secondary data from documented fraud cases and published audit...This study explores ethical violations and audit failures in various large-scale corporate fraud cases.Using a qualitative descriptive method and based on secondary data from documented fraud cases and published audit reports,the study applies the Fraud Triangle framework,focusing on how weak integrity,objectivity,and professional competence have undermined public trust in the auditing profession.Using a qualitative descriptive method and the Fraud Triangle framework,which includes pressure,opportunity,and rationalization,the study analyzes cases from Indonesia(SNP Finance,Jiwasraya),China(Evergrande),and Germany(Wirecard).The analysis reveals that many audit failures observed in this study appear to stem more from ethical challenges than from technical incapability,driven by client pressure,weak internal controls,and compromised auditor independence.These cases demonstrate a recurring global pattern in which auditors neglect their responsibility to act in the public interest.展开更多
Construction failures caused by unforeseen circumstances, such as natural disasters, environmental degradation, and structural weaknesses, present significant challenges in achieving durability, safety, and sustainabi...Construction failures caused by unforeseen circumstances, such as natural disasters, environmental degradation, and structural weaknesses, present significant challenges in achieving durability, safety, and sustainability. This research addresses these challenges through the development of advanced emergency rescue systems incorporating wood-derived nanomaterials and IoT-enabled Structural Health Monitoring (SHM) technologies. The use of nanocellulose which demonstrates outstanding mechanical capabilities and biodegradability alongside high resilience allowed developers to design modular rescue systems that function effectively even under challenging conditions while providing real-time failure protection. Experimental data from testing showed that the replacement system strengthened load-bearing limits by 20% while enhancing impact tolerance by 30% and decreasing lifecycle carbon footprints by 60% against conventional methods. FEA results alongside dynamic simulations established that the system maintains its strength across seismic events and thermal variations and environmental conditions. SHM systems that leverage the Internet of Things Platform revealed 95% accuracy rates in detecting anomalies while improving response speed by 30% for predictive maintenance operations. The innovative solutions support the special issue’s direction to push structural transformation through durable designs and creative materials with preventive failure solutions. The proposed solutions work together toward creating resilient infrastructure systems which resist unexpected stressors and environmental damage.展开更多
Cemented and mechanically clamped types of end fittings(fitting-C and fitting-M)are commonly used in transformer bushings.During the Luding Ms 6.8 earthquake that occurred in China on September 5,2022,all transformer ...Cemented and mechanically clamped types of end fittings(fitting-C and fitting-M)are commonly used in transformer bushings.During the Luding Ms 6.8 earthquake that occurred in China on September 5,2022,all transformer bushings with the two types of end fittings in a 500 kV substation were damaged.Post-earthquake field investigations were conducted,and the failures of the two types of bushings were compared.Two elementary simulation models of the transformer-bushing systems were developed to simulate the engineering failures,and further compute their seismic responses for comparison.The results indicate that the hitch lugs of the connection flange are structurally harmful to seismic resistance.Fitting-M can decrease the bending stiffness of the bushing due to the flexible sealing rubber gasket.Since it provides a more flexible connection that dissipates energy,the peak accelerations and relative displacements at the top of the bushing are significantly lower than those of the bushing with fitting-C.Compared with fitting-C,fitting-M transfers the high-stress areas from the connection flange to the root of the porcelain,so the latter becomes the most vulnerable component.Fitting-M increases the failure risk of the low-strength porcelain,indicating the unsuitability of applying it in high-intensity fortification regions.展开更多
BACKGROUND Advanced heart failure and transplant(AHFTC)teams are crucial in the management of patients in cardiogenic shock.We sought to explore the impact of AHFTC physicians on outcomes in patients receiving extraco...BACKGROUND Advanced heart failure and transplant(AHFTC)teams are crucial in the management of patients in cardiogenic shock.We sought to explore the impact of AHFTC physicians on outcomes in patients receiving extracorporeal membrane oxygenation(ECMO)support.AIM To determine whether outcomes differ in the care of ECMO patients when AHFTC physicians serve in a primary vs consultative role.METHODS We conducted a retrospective cohort study of 51 patients placed on veno-venous(VV)and veno-arterial(VA)ECMO between January 2015 and February 2023 at our institution.We compared ECMO outcomes between teams managed primarily by intensivists vs teams where AHFTC physicians played a direct role in ECMO management,including patient selection.Our primary outcome measure was survival to 30 days post hospital discharge.RESULTS For combined VA and VV ECMO patients,survival to 30 days post discharge in the AHFTC cohort was significantly higher(67%vs 30%,P=0.01),largely driven by a significantly increased 30-day post discharge survival in VA ECMO patients in the AHFTC group(64%vs 20%,P=0.05).CONCLUSION This study suggests that patients in shock requiring VA ECMO support may have improved survival 30 days after hospital discharge when an AHFTC team serves in a direct role in the selection and management of patients.Further studies are needed to validate this impact.展开更多
Double-integrator multi-agent systems(MASs)might not achieve dynamical consensus,even if only partial agents suffer from self-sensing function failures(SSFFs).SSFFs might be asynchronous in real engineering applicatio...Double-integrator multi-agent systems(MASs)might not achieve dynamical consensus,even if only partial agents suffer from self-sensing function failures(SSFFs).SSFFs might be asynchronous in real engineering application.The existing fault-tolerant dynamical consensus protocol suitable for synchronous SSFFs cannot be directly used to tackle fault-tolerant dynamical consensus of double-integrator MASs with partial agents subject to asynchronous SSFFs.Motivated by these facts,this paper explores a new fault-tolerant dynamical consensus protocol suitable for asynchronous SSFFs.First,multi-hop communication together with the idea of treating asynchronous SSFFs as multiple piecewise synchronous SSFFs is used for recovering the connectivity of network topology among all normal agents.Second,a fault-tolerant dynamical consensus protocol is designed for double-integrator MASs by utilizing the history information of an agent subject to SSFF for computing its own state information at the instants when its minimum-hop normal neighbor set changes.Then,it is theoretically proved that if the strategy of network topology connectivity recovery and the fault-tolerant dynamical consensus protocol with proper time-varying gains are used simultaneously,double-integrator MASs with all normal agents and all agents subject to SSFFs can reach dynamical consensus.Finally,comparison numerical simulations are given to illustrate the effectiveness of the theoretical results.展开更多
Reinforced concrete(RC)slabs are the primary load-carrying member of underwater facilities.They can suffer severe local failures such as cratering,spalling,or breaching as a result of underwater close-in(UWCI)explosio...Reinforced concrete(RC)slabs are the primary load-carrying member of underwater facilities.They can suffer severe local failures such as cratering,spalling,or breaching as a result of underwater close-in(UWCI)explosions.In this study,we established a fully validated high-fidelity finite element analysis approach to precisely reproduce the local failures of RC slabs after a UWCI explosion.A recently proposed dynamic constitutive model is used to describe wet concrete.The effects of free water content on the material properties,including the tensile/compressive strength,elastic modulus,strain rate effect,failure strength surface,and equation of state,are comprehensively calibrated based on existing test data.The calibrated material parameters are then verified by a single-element test.A high-fidelity finite element analysis(FEA)approach of an RC slab subjected to a UWCI explosion is established using an arbitrary Lagrangian-Eulerian(ALE)algorithm.Simulating previous UWCI explosion tests on RC orifice targets and underwater contact explosion tests on saturated concrete slabs showed that the established FEA approach could accurately reproduce the pressure-time history in water and damage patterns,including the cracking,cratering,and spalling,of the RC orifice target and saturated concrete slab.Furthermore,parametric studies conducted by simulating an RC slab subjected to a UWCI explosion showed that:(i)the local failure of an RC slab enlarges with increased charge weight,reduced standoff distance,and reduced structural thickness;(ii)compared to a water-backed RC slab,an air-backed RC slab exhibits much more obvious local and structural failure.Lastly,to aid the anti-explosion design of relevant underwater facilities,based on over 90 simulation cases empirical formulae are summarized to predict local failure modes,i.e.,no spall,spall,and breach,of water-and air-backed RC slabs subjected to a UWCI explosion.展开更多
BACKGROUND Acute pancreatitis(AP)is a severe condition,and abdominal effusion is a significant predictor of its severity and prognosis.However,the relationship between ascites characteristics and AP outcomes remains u...BACKGROUND Acute pancreatitis(AP)is a severe condition,and abdominal effusion is a significant predictor of its severity and prognosis.However,the relationship between ascites characteristics and AP outcomes remains undefined.AIM To assess the correlation between ascites characteristics and clinical prognosis in AP patients by comparing color depth and turbidity of early ascites.METHODS This study included 667 AP patients with ascites,categorized by color and turbidity into yellow clear(n=54),yellow turbid(n=293),red brown(n=320).The trendχ2 test was employed to analyze the incidence of organ failure(OF),infected pancreatic necrosis(IPN),and mortality across groups.Receiver operating charac teristic(ROC)curves were used to evaluate the predictive value of ascites cell count,amylase,protein,and lactate dehydrogenase(LDH)for abdominal compartment syndrome(ACS)and intra-abdominal hemorrhage.RESULTS AP patients with ascites exhibited higher scores of scoring systems(such as Bedside index for severity in AP,Acute Physiology and Chronic Health Examination II,etc.)and increased complications and mortality rates(all P<0.05)compared to those without ascites.A linear association was observed between ascites color depth and turbidity and the incidence of OF,pancreatic necrosis,IPN,and mortality(P<0.05).LDH in ascites demonstrated high accuracy in predicting ACS and intra-abdominal hemorrhage,with areas under the ROC curve of 0.77 and 0.79,respectively.CONCLUSION Early in AP,ascites correlates with OF,IPN,and mortality,showing linear associations with color depth and turbidity.Ascitic LDH reliably predicts ACS and intra-abdominal hemorrhage in AP patients.展开更多
BACKGROUND Acute liver failure(ALF)is a life-threatening multisystemic condition with high short-term mortality.With the growing prevalence of obesity and metabolic syndrome,it is important to investigate the clinical...BACKGROUND Acute liver failure(ALF)is a life-threatening multisystemic condition with high short-term mortality.With the growing prevalence of obesity and metabolic syndrome,it is important to investigate the clinical implications of high body mass index(BMI)on survival outcomes in ALF.AIM To explore the impact of overweight and obesity on the clinical outcomes of patients with ALF.METHODS A retrospective observational cohort study was conducted involving patients with ALF admitted to the Johns Hopkins Health System between January 1,2000 and May 1,2020.We performed Cox proportional hazards regression to identify outcomes,including the need for liver transplantation(LT)or all-cause mortality.RESULTS A total of 196 patients were included,the median age was 43.5 years,63.3%were female,and 59.7%were of Caucasian ethnicity.Acetaminophen-induced ALF was the most common etiology(45%).The mean BMI was significantly greater among patients who underwent LT or died(29.64 kg/m^(2)vs 26.59 kg/m^(2),P=0.008)than among survivors.Patients with overweight and obesity had a higher risk of all-cause mortality or need for LT by 2.22-fold(95%CI:1.30-3.78)and 2.04-fold(95%CI:1.29-3.39),respectively.Elevated BMI was associated with renal failure and higher grades of hepatic encephalopathy.Derangements in serologic markers,including alanine transaminase,lactate,and ammonia,were associated with a mortality risk or need for LT.CONCLUSION In this large,retrospective study,with a diverse cohort of United States patients,Overweight and obese were independently associated with an increased risk of all-cause mortality or need for LT.This work highlights the importance of closely monitoring ALF patients who are overweight or obese for adverse complications and measures to improve outcomes in this vulnerable patient population.展开更多
Link failure is a critical issue in large networks and must be effectively addressed.In software-defined networks(SDN),link failure recovery schemes can be categorized into proactive and reactive approaches.Reactive s...Link failure is a critical issue in large networks and must be effectively addressed.In software-defined networks(SDN),link failure recovery schemes can be categorized into proactive and reactive approaches.Reactive schemes have longer recovery times while proactive schemes provide faster recovery but overwhelm the memory of switches by flow entries.As SDN adoption grows,ensuring efficient recovery from link failures in the data plane becomes crucial.In particular,data center networks(DCNs)demand rapid recovery times and efficient resource utilization to meet carrier-grade requirements.This paper proposes an efficient Decentralized Failure Recovery(DFR)model for SDNs,meeting recovery time requirements and optimizing switch memory resource consumption.The DFR model enables switches to autonomously reroute traffic upon link failures without involving the controller,achieving fast recovery times while minimizing memory usage.DFR employs the Fast Failover Group in the OpenFlow standard for local recovery without requiring controller communication and utilizes the k-shortest path algorithm to proactively install backup paths,allowing immediate local recovery without controller intervention and enhancing overall network stability and scalability.DFR employs flow entry aggregation techniques to reduce switch memory usage.Instead of matching flow entries to the destination host’s MAC address,DFR matches packets to the destination switch’s MAC address.This reduces the switches’Ternary Content-Addressable Memory(TCAM)consumption.Additionally,DFR modifies Address Resolution Protocol(ARP)replies to provide source hosts with the destination switch’s MAC address,facilitating flow entry aggregation without affecting normal network operations.The performance of DFR is evaluated through the network emulator Mininet 2.3.1 and Ryu 3.1 as SDN controller.For different number of active flows,number of hosts per edge switch,and different network sizes,the proposed model outperformed various failure recovery models:restoration-based,protection by flow entries,protection by group entries and protection by Vlan-tagging model in terms of recovery time,switch memory consumption and controller overhead which represented the number of flow entry updates to recover from the failure.Experimental results demonstrate that DFR achieves recovery times under 20 milliseconds,satisfying carrier-grade requirements for rapid failure recovery.Additionally,DFR reduces switch memory usage by up to 95%compared to traditional protection methods and minimizes controller load by eliminating the need for controller intervention during failure recovery.Theresults underscore the efficiency and scalability of the DFR model,making it a practical solution for enhancing network resilience in SDN environments.展开更多
Software-defined networking(SDN)is an innovative paradigm that separates the control and data planes,introducing centralized network control.SDN is increasingly being adopted by Carrier Grade networks,offering enhance...Software-defined networking(SDN)is an innovative paradigm that separates the control and data planes,introducing centralized network control.SDN is increasingly being adopted by Carrier Grade networks,offering enhanced networkmanagement capabilities than those of traditional networks.However,because SDN is designed to ensure high-level service availability,it faces additional challenges.One of themost critical challenges is ensuring efficient detection and recovery from link failures in the data plane.Such failures can significantly impact network performance and lead to service outages,making resiliency a key concern for the effective adoption of SDN.Since the recovery process is intrinsically dependent on timely failure detection,this research surveys and analyzes the current literature on both failure detection and recovery approaches in SDN.The survey provides a critical comparison of existing failure detection techniques,highlighting their advantages and disadvantages.Additionally,it examines the current failure recovery methods,categorized as either restoration-based or protection-based,and offers a comprehensive comparison of their strengths and limitations.Lastly,future research challenges and directions are discussed to address the shortcomings of existing failure recovery methods.展开更多
According to the Japanese Ministry of Health,Labour,and Welfare,14.2%of people were aged>75 years in Japan in 2018,and this number continues to rise.With population aging,the incidence of congestive heart failure(C...According to the Japanese Ministry of Health,Labour,and Welfare,14.2%of people were aged>75 years in Japan in 2018,and this number continues to rise.With population aging,the incidence of congestive heart failure(CHF)is also increasing.[1–3]Reports have shown that the presence of cognitive impairment(CI)in patients with CHF is associated with poor prognosis,[4–6]and the degree of CI is related to CHF severity.展开更多
Patients with advanced liver cirrhosis and liver failure frequently experience abnormalities in their serum electrolyte levels.In such patients,hyponatremia has been identified as a predictor of poor outcomes.However,...Patients with advanced liver cirrhosis and liver failure frequently experience abnormalities in their serum electrolyte levels.In such patients,hyponatremia has been identified as a predictor of poor outcomes.However,emerging evidence suggests that serum chloride may provide even better prognostic information in similar situations.Hypochloremia,characterised by low serum chloride levels,has been linked to increased mortality,exacerbated organ dysfunction,and higher requirements for renal replacement therapy and vasopressors in various critical conditions,including advanced liver diseases.The pathophysiological mecha-nisms underlying the association between low serum chloride levels and poor outcomes in liver disease appear to involve complex interactions among electro-lyte imbalances,renal function,and systemic hemodynamics.Chloride dysregu-lation can influence renal salt-sensing mechanisms,disrupt acid-base homeostasis,and exacerbate complications such as hepatic encephalopathy and hepatorenal syndrome.This article aims to elucidate the prognostic significance of lower serum chloride levels in patients with advanced liver disease.By reviewing recent literature and analysing clinical data,we seek to establish serum chloride as an underutilised but valuable prognostic marker.Understanding the role of serum chloride in liver disease could enhance prognostic accuracy,refine treatment strategies,and ultimately improve patient outcomes.展开更多
Lingguizhugan Decoction(LGZG)demonstrates significant efficacy in treating various cardiovascular diseases clinically,yet its precise mechanism of action remains elusive.This study aimed to elucidate the potential mec...Lingguizhugan Decoction(LGZG)demonstrates significant efficacy in treating various cardiovascular diseases clinically,yet its precise mechanism of action remains elusive.This study aimed to elucidate the potential mechanisms and effects of LGZG on isoproterenol(ISO)continuous stimulation-induced chronic heart failure(CHF)in mice,providing direct experimental evidence for further clinical applications.In vivo,continuous ISO infusion was administered to mice,and ventricular myocytes were utilized to explore LGZG's potential mechanism of action on theβ1-adrenergic receptor(β1-AR)/Gs/G protein-coupled receptor kinases(GRKs)/β-arrestin signaling deflection system in the heart.The findings reveal that LGZG significantly reduced the messenger ribonucleic acid(mRNA)expression of hypertrophy-related biomarkers[atrial natriuretic peptide(ANP)and B-type natriuretic peptide(BNP)]and improved cardiac remodeling and left ventricular diastolic function in mice with ISO-induced CHF.Furthermore,LGZG inhibited the overactivation of Gs/cyclic adenosine monophosphate(c AMP)/protein kinase A(PKA)signaling and downregulated the downstream transcriptional activity of c AMP-response element binding protein(CREB)and the expression of the coactivator CBP/P300.Notably,LGZG downregulated the expression ofβ-arrestin1 and GRK 2/3/5 while upregulating the expression ofβ1-AR andβ-arrestin2.These results suggest that LGZG inhibits Gs/c AMP/PKA signaling andβ-arrestin/GRK-mediated desensitization and internalization ofβ1-AR,potentially exerting cardioprotective effects through the synergistic regulation of theβ1-AR/Gs/GRKs/β-arrestin signaling deflection system via multiple pathways.展开更多
BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread ...BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread challenge in the management of CHF.To effectively manage disease progression and alleviate symptoms,it is crucial to identify key influencing factors to facilitate the implementation of targeted interventions.AIM To investigate the status of anxiety and depression among patients with CHF and determine the factors contributing to poor fluid restriction adherence.METHODS Three hundred CHF patients seeking medical treatment at The First Hospital of Hunan University of Traditional Chinese Medicine between June 2021 and June 2023 were included in the study.Questionnaires,including the Psychosomatic Symptom Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and Fluid Restriction Adherence Questionnaire were administered to patients.Based on their anxiety and depression scores,patients were categorized into anxiety/depression and non-anxiety/depression groups,as well as fluid restriction adherence and fluid restriction non-adherence groups.General patient data were collected,and univariate and logistic regression analyses were conducted to determine the occurrence of depression and anxiety.Logistic regression analysis was used to identify independent factors influencing fluid restriction adherence.RESULTS Statistically significant differences in age,New York Heart Association(NYHA)grading,marital status,educational attainment,and family support were observed between depressed and non-depressed CHF patients(P<0.05).Age,NYHA grading,marital status,educational attainment,and family support were identified as factors influencing the development of depression.The anxiety and non-anxiety groups differed statistically in terms of gender,age,NYHA grading,smoking history,alcohol consumption history,monthly income,educational attainment,and family support(P<0.05).Gender,smoking,alcohol consumption,monthly income,and educational attainment affected anxiety in these patients.The fluid restriction adherence rate was 28.0%,and thirst sensation,anxiety,and depression were identified as independent influencing factors.CONCLUSION CHF patients are susceptible to anxiety and depression,with multiple associated influencing factors.Moreover,anxiety and depression are independent factors that can influence fluid restriction adherence in these patients.展开更多
BACKGROUND Research examining the relationships among anxiety,depression,self-perceived burden(SPB),and psychological resilience(PR),along with the determinants of PR,in patients with chronic renal failure(CRF)receivi...BACKGROUND Research examining the relationships among anxiety,depression,self-perceived burden(SPB),and psychological resilience(PR),along with the determinants of PR,in patients with chronic renal failure(CRF)receiving maintenance hemodia-lysis(MHD)is limited.AIM To investigate the correlation between anxiety,depression,SPB,and PR in pati-ents with CRF on MHD.METHODS This study included 225 patients with CRF on MHD who were admitted between June 2021 and June 2024.The anxiety level was evaluated using the Self-Rating Anxiety Scale(SAS);the depression status was assessed using the Self-Rating Depression Scale(SDS);the SPB was measured using the SPB Scale(SPBS);and the PR was determined using the Connor–Davidson Resilience Scale(CD-RISC).The correlations among the SAS,SDS,SPB,and CD-RISC were analyzed using Pearson’s correlation coefficients.Univariate and multivariate analyses were performed to identify the factors that influence the PR of patients with CRF on MHD.RESULTS The SAS,SDS,SPB,and CD-RISC scores of the 225 patients were 45.25±15.36,54.81±14.68,32.31±11.52,and 66.48±9.18,respectively.Significant negative correlations were observed between SAS,SDS,SPB,and CD-RISC.Furthermore,longer dialysis vintage(P=0.015),the absence of religious beliefs(P=0.020),lower monthly income(P=0.008),higher SAS score(P=0.013),and higher SDS score(P=0.006)were all independent factors that adversely affected the PR of patients with CRF on MHD.CONCLUSION Patients with CRF on MHD present with varying degrees of anxiety,depression,and SPB,all of which exhibit a significant negative correlation with their PR.Moreover,longer dialysis vintage,the absence of religious beliefs,lower monthly income,higher SAS score,and higher SDS score were factors that negatively affected the PR of patients with CRF on MHD.展开更多
基金Supported by National Natural Science Foundation of China,No.82271546 and No.82301744The Shanxi Province Science and Technology Innovation Think Tank Construction Research Project,No.KXKT202317+1 种基金Fundamental Research Program of Shanxi Province,No.202303021222346 and No.202103021223224The Research Foundation of The First Hospital of Shanxi Medical University,No.YQ2208.
文摘BACKGROUND The coronavirus disease 2019 pandemic has had an ongoing impact on the public’s mental health that requires long-term attention.Exploring the relationship between mental health indicators would aid in identifying solutions to improve public mental health.AIM To investigate the prevalence of anxiety,depression,and insomnia and explore the relationship among neuroticism,cognitive failures,and mental health.METHODS A cross-sectional survey was conducted in December 2023 using an online platform to recruit adult participants.The neuroticism,subjective cognitive function,and mental health of the participants were assessed using the neuroticism subscale of the Chinese Big Five Personality Inventory Brief Version,cognitive failures questionnaire,generalized anxiety disorder-7,patient health questionnaire-9,and insomnia severity index.Pearson's correlation analysis,independent samples t-tests,one-way analysis of variance,and structural equation model were used to examine the relationship between mental health indicators.RESULTS A total of 1011 valid questionnaires were collected,of which 343 were completed by male(33.93%)respondents and 668 were completed by female(66.07%)respondents.The rates of anxiety,depression,and insomnia were 41.3%,44.6%,and 36.3%,respectively,most cases of which were mild.Among the mental health indicators,there were significant differences by age and between those with siblings and those who were only children.Neuroticism and cognitive failures were significantly positively correlated with mental health indicators.Further moderated mediation analysis showed that cognitive failures mediated the relationship between insomnia and anxiety and between insomnia and depression,with neuroticism moderating the first half of this pathway and the effect being greater in the low-neuroticism group.CONCLUSION Cognitive failures and neuroticism play important roles in mental health.Therefore,enhancing subjective cognitive function and regulating emotional stability may contribute to the improvement of mental health.
基金funded by the Key Research and Development Project of Guangdong Province(No.2023B0909050004)the National Natural Science Foundation of China(No.12402214).
文摘The insertion and extraction of lithium ions in active materials lead to significant volumetric deformation,resulting in stresses that drive the mechanical degradation of these materials.This accumulation of mechanical degradation ultimately leads to mechanical failure in lithium-ion batteries(LIB).This paper summarizes the experimental characterization techniques used to observe the mechanical degradation of lithium battery cells,electrodes,and particles across macro,micro,and nano scales.Additionally,the mechanical failure model for LIB that spans from the microscopic to the macroscopic scale has been outlined.Finally,we analyze the current challenges and opportunities,including the standardization of battery measurements,the quantification of mechanical failures,and the correlation between mechanical failures and electrochemical performance.
基金supported by the National Social Science Fund Project(No.23&ZD115)the Graduate Student Research Innovation Project of the School of Mathematics and Statistics,Hubei Minzu University(No.STK2023011)。
文摘Compared to single-layer networks,multilayer networks exhibit a more complex node degree composition,comprising both intra-layer and inter-layer degrees.However,the distinct impacts of these degree types on cascading failures remain underexplored.Distinguishing their effects is crucial for a deeper understanding of network structure,information propagation,and behavior prediction.This paper proposes a capacity-load model to influence and compare the influence of different degree types on cascading failures in multilayer networks.By designing three node removal strategies based on total degree,intra-layer degree,and inter-layer degree,simulation experiments are conducted on four types of networks.Network robustness is evaluated using the maximum number of removable nodes before collapse.The relationships between network robustness and the coupling coefficient,as well as load and capacity adjustment parameters,are also analyzed.The results indicate that the node removal strategy with the least impact on cascading failures varies across different types of networks,revealing the significance of different node degrees in failure propagation.Compared to other models,the proposed model enables networks to maintain a higher maximum number of removable nodes during cascading failures,demonstrating superior robustness.
基金supported by the National Key Research and Development Program of China"Key technologies for system stability and HVDC transmission of large-scale renewable energy generation base without conventional power support(2022YFB2402700)"the project of the State Grid Corporation of China(52272222001J).
文摘In wind and solar renewable-dominant hybrid alternating current/direct current(AC/DC)power systems,the active power of high-voltage direct current(HVDC)system is significantly limited by the security and stability events caused by cascading failures.To identify critical lines in cascading failures,a rapid risk assessment method is proposed based on the gradient boosting decision tree(GBDT)and frequent pat-tern growth(FP-Growth)algorithms.First,security and stability events triggered by cascading failures are analyzed to explain the impact of cascading failures on the maximum DC power.Then,a cascading failure risk index is defined,focusing on the DC power being limited.To handle the strong nonlinear relationship between the maximum DC power and cascading failures,a GBDT with an update strategy is utilized to rapidly predict the maximum DC power under uncertain operating conditions.Finally,the FP-Growth algorithm is improved to mine frequent patterns in cascading failures.The importance index for each fault in a frequent pattern is defined by evaluating its impact on cascading failures,enabling the identification of critical lines.Simulation results of a modified Ningxia–Shandong hybrid AC/DC system in China demonstrate that the proposed method can rapidly assess the risk of cascading failures and effectively identify critical lines.
文摘This study explores ethical violations and audit failures in various large-scale corporate fraud cases.Using a qualitative descriptive method and based on secondary data from documented fraud cases and published audit reports,the study applies the Fraud Triangle framework,focusing on how weak integrity,objectivity,and professional competence have undermined public trust in the auditing profession.Using a qualitative descriptive method and the Fraud Triangle framework,which includes pressure,opportunity,and rationalization,the study analyzes cases from Indonesia(SNP Finance,Jiwasraya),China(Evergrande),and Germany(Wirecard).The analysis reveals that many audit failures observed in this study appear to stem more from ethical challenges than from technical incapability,driven by client pressure,weak internal controls,and compromised auditor independence.These cases demonstrate a recurring global pattern in which auditors neglect their responsibility to act in the public interest.
文摘This study explores ethical violations and audit failures in various large-scale corporate fraud cases.Using a qualitative descriptive method and based on secondary data from documented fraud cases and published audit reports,the study applies the Fraud Triangle framework,focusing on how weak integrity,objectivity,and professional competence have undermined public trust in the auditing profession.Using a qualitative descriptive method and the Fraud Triangle framework,which includes pressure,opportunity,and rationalization,the study analyzes cases from Indonesia(SNP Finance,Jiwasraya),China(Evergrande),and Germany(Wirecard).The analysis reveals that many audit failures observed in this study appear to stem more from ethical challenges than from technical incapability,driven by client pressure,weak internal controls,and compromised auditor independence.These cases demonstrate a recurring global pattern in which auditors neglect their responsibility to act in the public interest.
文摘Construction failures caused by unforeseen circumstances, such as natural disasters, environmental degradation, and structural weaknesses, present significant challenges in achieving durability, safety, and sustainability. This research addresses these challenges through the development of advanced emergency rescue systems incorporating wood-derived nanomaterials and IoT-enabled Structural Health Monitoring (SHM) technologies. The use of nanocellulose which demonstrates outstanding mechanical capabilities and biodegradability alongside high resilience allowed developers to design modular rescue systems that function effectively even under challenging conditions while providing real-time failure protection. Experimental data from testing showed that the replacement system strengthened load-bearing limits by 20% while enhancing impact tolerance by 30% and decreasing lifecycle carbon footprints by 60% against conventional methods. FEA results alongside dynamic simulations established that the system maintains its strength across seismic events and thermal variations and environmental conditions. SHM systems that leverage the Internet of Things Platform revealed 95% accuracy rates in detecting anomalies while improving response speed by 30% for predictive maintenance operations. The innovative solutions support the special issue’s direction to push structural transformation through durable designs and creative materials with preventive failure solutions. The proposed solutions work together toward creating resilient infrastructure systems which resist unexpected stressors and environmental damage.
基金National Natural Science Foundation of China under Grant No.51878508。
文摘Cemented and mechanically clamped types of end fittings(fitting-C and fitting-M)are commonly used in transformer bushings.During the Luding Ms 6.8 earthquake that occurred in China on September 5,2022,all transformer bushings with the two types of end fittings in a 500 kV substation were damaged.Post-earthquake field investigations were conducted,and the failures of the two types of bushings were compared.Two elementary simulation models of the transformer-bushing systems were developed to simulate the engineering failures,and further compute their seismic responses for comparison.The results indicate that the hitch lugs of the connection flange are structurally harmful to seismic resistance.Fitting-M can decrease the bending stiffness of the bushing due to the flexible sealing rubber gasket.Since it provides a more flexible connection that dissipates energy,the peak accelerations and relative displacements at the top of the bushing are significantly lower than those of the bushing with fitting-C.Compared with fitting-C,fitting-M transfers the high-stress areas from the connection flange to the root of the porcelain,so the latter becomes the most vulnerable component.Fitting-M increases the failure risk of the low-strength porcelain,indicating the unsuitability of applying it in high-intensity fortification regions.
文摘BACKGROUND Advanced heart failure and transplant(AHFTC)teams are crucial in the management of patients in cardiogenic shock.We sought to explore the impact of AHFTC physicians on outcomes in patients receiving extracorporeal membrane oxygenation(ECMO)support.AIM To determine whether outcomes differ in the care of ECMO patients when AHFTC physicians serve in a primary vs consultative role.METHODS We conducted a retrospective cohort study of 51 patients placed on veno-venous(VV)and veno-arterial(VA)ECMO between January 2015 and February 2023 at our institution.We compared ECMO outcomes between teams managed primarily by intensivists vs teams where AHFTC physicians played a direct role in ECMO management,including patient selection.Our primary outcome measure was survival to 30 days post hospital discharge.RESULTS For combined VA and VV ECMO patients,survival to 30 days post discharge in the AHFTC cohort was significantly higher(67%vs 30%,P=0.01),largely driven by a significantly increased 30-day post discharge survival in VA ECMO patients in the AHFTC group(64%vs 20%,P=0.05).CONCLUSION This study suggests that patients in shock requiring VA ECMO support may have improved survival 30 days after hospital discharge when an AHFTC team serves in a direct role in the selection and management of patients.Further studies are needed to validate this impact.
基金National Natural Science Foundation of China(No.61876073)Fundamental Research Funds for the Central Universities of China(No.JUSRP21920)。
文摘Double-integrator multi-agent systems(MASs)might not achieve dynamical consensus,even if only partial agents suffer from self-sensing function failures(SSFFs).SSFFs might be asynchronous in real engineering application.The existing fault-tolerant dynamical consensus protocol suitable for synchronous SSFFs cannot be directly used to tackle fault-tolerant dynamical consensus of double-integrator MASs with partial agents subject to asynchronous SSFFs.Motivated by these facts,this paper explores a new fault-tolerant dynamical consensus protocol suitable for asynchronous SSFFs.First,multi-hop communication together with the idea of treating asynchronous SSFFs as multiple piecewise synchronous SSFFs is used for recovering the connectivity of network topology among all normal agents.Second,a fault-tolerant dynamical consensus protocol is designed for double-integrator MASs by utilizing the history information of an agent subject to SSFF for computing its own state information at the instants when its minimum-hop normal neighbor set changes.Then,it is theoretically proved that if the strategy of network topology connectivity recovery and the fault-tolerant dynamical consensus protocol with proper time-varying gains are used simultaneously,double-integrator MASs with all normal agents and all agents subject to SSFFs can reach dynamical consensus.Finally,comparison numerical simulations are given to illustrate the effectiveness of the theoretical results.
基金supported by the National Natural Science Foundation of China(No.52208500).
文摘Reinforced concrete(RC)slabs are the primary load-carrying member of underwater facilities.They can suffer severe local failures such as cratering,spalling,or breaching as a result of underwater close-in(UWCI)explosions.In this study,we established a fully validated high-fidelity finite element analysis approach to precisely reproduce the local failures of RC slabs after a UWCI explosion.A recently proposed dynamic constitutive model is used to describe wet concrete.The effects of free water content on the material properties,including the tensile/compressive strength,elastic modulus,strain rate effect,failure strength surface,and equation of state,are comprehensively calibrated based on existing test data.The calibrated material parameters are then verified by a single-element test.A high-fidelity finite element analysis(FEA)approach of an RC slab subjected to a UWCI explosion is established using an arbitrary Lagrangian-Eulerian(ALE)algorithm.Simulating previous UWCI explosion tests on RC orifice targets and underwater contact explosion tests on saturated concrete slabs showed that the established FEA approach could accurately reproduce the pressure-time history in water and damage patterns,including the cracking,cratering,and spalling,of the RC orifice target and saturated concrete slab.Furthermore,parametric studies conducted by simulating an RC slab subjected to a UWCI explosion showed that:(i)the local failure of an RC slab enlarges with increased charge weight,reduced standoff distance,and reduced structural thickness;(ii)compared to a water-backed RC slab,an air-backed RC slab exhibits much more obvious local and structural failure.Lastly,to aid the anti-explosion design of relevant underwater facilities,based on over 90 simulation cases empirical formulae are summarized to predict local failure modes,i.e.,no spall,spall,and breach,of water-and air-backed RC slabs subjected to a UWCI explosion.
基金Supported by National Natural Science Foundation of China,No.82360136Jiangxi Clinical Research Center for Gastroenterology,No.20223BCG74011.
文摘BACKGROUND Acute pancreatitis(AP)is a severe condition,and abdominal effusion is a significant predictor of its severity and prognosis.However,the relationship between ascites characteristics and AP outcomes remains undefined.AIM To assess the correlation between ascites characteristics and clinical prognosis in AP patients by comparing color depth and turbidity of early ascites.METHODS This study included 667 AP patients with ascites,categorized by color and turbidity into yellow clear(n=54),yellow turbid(n=293),red brown(n=320).The trendχ2 test was employed to analyze the incidence of organ failure(OF),infected pancreatic necrosis(IPN),and mortality across groups.Receiver operating charac teristic(ROC)curves were used to evaluate the predictive value of ascites cell count,amylase,protein,and lactate dehydrogenase(LDH)for abdominal compartment syndrome(ACS)and intra-abdominal hemorrhage.RESULTS AP patients with ascites exhibited higher scores of scoring systems(such as Bedside index for severity in AP,Acute Physiology and Chronic Health Examination II,etc.)and increased complications and mortality rates(all P<0.05)compared to those without ascites.A linear association was observed between ascites color depth and turbidity and the incidence of OF,pancreatic necrosis,IPN,and mortality(P<0.05).LDH in ascites demonstrated high accuracy in predicting ACS and intra-abdominal hemorrhage,with areas under the ROC curve of 0.77 and 0.79,respectively.CONCLUSION Early in AP,ascites correlates with OF,IPN,and mortality,showing linear associations with color depth and turbidity.Ascitic LDH reliably predicts ACS and intra-abdominal hemorrhage in AP patients.
文摘BACKGROUND Acute liver failure(ALF)is a life-threatening multisystemic condition with high short-term mortality.With the growing prevalence of obesity and metabolic syndrome,it is important to investigate the clinical implications of high body mass index(BMI)on survival outcomes in ALF.AIM To explore the impact of overweight and obesity on the clinical outcomes of patients with ALF.METHODS A retrospective observational cohort study was conducted involving patients with ALF admitted to the Johns Hopkins Health System between January 1,2000 and May 1,2020.We performed Cox proportional hazards regression to identify outcomes,including the need for liver transplantation(LT)or all-cause mortality.RESULTS A total of 196 patients were included,the median age was 43.5 years,63.3%were female,and 59.7%were of Caucasian ethnicity.Acetaminophen-induced ALF was the most common etiology(45%).The mean BMI was significantly greater among patients who underwent LT or died(29.64 kg/m^(2)vs 26.59 kg/m^(2),P=0.008)than among survivors.Patients with overweight and obesity had a higher risk of all-cause mortality or need for LT by 2.22-fold(95%CI:1.30-3.78)and 2.04-fold(95%CI:1.29-3.39),respectively.Elevated BMI was associated with renal failure and higher grades of hepatic encephalopathy.Derangements in serologic markers,including alanine transaminase,lactate,and ammonia,were associated with a mortality risk or need for LT.CONCLUSION In this large,retrospective study,with a diverse cohort of United States patients,Overweight and obese were independently associated with an increased risk of all-cause mortality or need for LT.This work highlights the importance of closely monitoring ALF patients who are overweight or obese for adverse complications and measures to improve outcomes in this vulnerable patient population.
文摘Link failure is a critical issue in large networks and must be effectively addressed.In software-defined networks(SDN),link failure recovery schemes can be categorized into proactive and reactive approaches.Reactive schemes have longer recovery times while proactive schemes provide faster recovery but overwhelm the memory of switches by flow entries.As SDN adoption grows,ensuring efficient recovery from link failures in the data plane becomes crucial.In particular,data center networks(DCNs)demand rapid recovery times and efficient resource utilization to meet carrier-grade requirements.This paper proposes an efficient Decentralized Failure Recovery(DFR)model for SDNs,meeting recovery time requirements and optimizing switch memory resource consumption.The DFR model enables switches to autonomously reroute traffic upon link failures without involving the controller,achieving fast recovery times while minimizing memory usage.DFR employs the Fast Failover Group in the OpenFlow standard for local recovery without requiring controller communication and utilizes the k-shortest path algorithm to proactively install backup paths,allowing immediate local recovery without controller intervention and enhancing overall network stability and scalability.DFR employs flow entry aggregation techniques to reduce switch memory usage.Instead of matching flow entries to the destination host’s MAC address,DFR matches packets to the destination switch’s MAC address.This reduces the switches’Ternary Content-Addressable Memory(TCAM)consumption.Additionally,DFR modifies Address Resolution Protocol(ARP)replies to provide source hosts with the destination switch’s MAC address,facilitating flow entry aggregation without affecting normal network operations.The performance of DFR is evaluated through the network emulator Mininet 2.3.1 and Ryu 3.1 as SDN controller.For different number of active flows,number of hosts per edge switch,and different network sizes,the proposed model outperformed various failure recovery models:restoration-based,protection by flow entries,protection by group entries and protection by Vlan-tagging model in terms of recovery time,switch memory consumption and controller overhead which represented the number of flow entry updates to recover from the failure.Experimental results demonstrate that DFR achieves recovery times under 20 milliseconds,satisfying carrier-grade requirements for rapid failure recovery.Additionally,DFR reduces switch memory usage by up to 95%compared to traditional protection methods and minimizes controller load by eliminating the need for controller intervention during failure recovery.Theresults underscore the efficiency and scalability of the DFR model,making it a practical solution for enhancing network resilience in SDN environments.
文摘Software-defined networking(SDN)is an innovative paradigm that separates the control and data planes,introducing centralized network control.SDN is increasingly being adopted by Carrier Grade networks,offering enhanced networkmanagement capabilities than those of traditional networks.However,because SDN is designed to ensure high-level service availability,it faces additional challenges.One of themost critical challenges is ensuring efficient detection and recovery from link failures in the data plane.Such failures can significantly impact network performance and lead to service outages,making resiliency a key concern for the effective adoption of SDN.Since the recovery process is intrinsically dependent on timely failure detection,this research surveys and analyzes the current literature on both failure detection and recovery approaches in SDN.The survey provides a critical comparison of existing failure detection techniques,highlighting their advantages and disadvantages.Additionally,it examines the current failure recovery methods,categorized as either restoration-based or protection-based,and offers a comprehensive comparison of their strengths and limitations.Lastly,future research challenges and directions are discussed to address the shortcomings of existing failure recovery methods.
文摘According to the Japanese Ministry of Health,Labour,and Welfare,14.2%of people were aged>75 years in Japan in 2018,and this number continues to rise.With population aging,the incidence of congestive heart failure(CHF)is also increasing.[1–3]Reports have shown that the presence of cognitive impairment(CI)in patients with CHF is associated with poor prognosis,[4–6]and the degree of CI is related to CHF severity.
文摘Patients with advanced liver cirrhosis and liver failure frequently experience abnormalities in their serum electrolyte levels.In such patients,hyponatremia has been identified as a predictor of poor outcomes.However,emerging evidence suggests that serum chloride may provide even better prognostic information in similar situations.Hypochloremia,characterised by low serum chloride levels,has been linked to increased mortality,exacerbated organ dysfunction,and higher requirements for renal replacement therapy and vasopressors in various critical conditions,including advanced liver diseases.The pathophysiological mecha-nisms underlying the association between low serum chloride levels and poor outcomes in liver disease appear to involve complex interactions among electro-lyte imbalances,renal function,and systemic hemodynamics.Chloride dysregu-lation can influence renal salt-sensing mechanisms,disrupt acid-base homeostasis,and exacerbate complications such as hepatic encephalopathy and hepatorenal syndrome.This article aims to elucidate the prognostic significance of lower serum chloride levels in patients with advanced liver disease.By reviewing recent literature and analysing clinical data,we seek to establish serum chloride as an underutilised but valuable prognostic marker.Understanding the role of serum chloride in liver disease could enhance prognostic accuracy,refine treatment strategies,and ultimately improve patient outcomes.
基金supported by the National Natural Science Foundation of China(No.82074054)Shanghai Municipal Commission of Health and Family Planning(No.ZY(2021-2023)-0208)+2 种基金Youth Program of the National Natural Science Foundation of China(No.81903831)Shanghai Municipality:Shanghai Chenguang Program(No.19CG48)Natural Science Foundation of Shanghai(No.24ZR1465900)。
文摘Lingguizhugan Decoction(LGZG)demonstrates significant efficacy in treating various cardiovascular diseases clinically,yet its precise mechanism of action remains elusive.This study aimed to elucidate the potential mechanisms and effects of LGZG on isoproterenol(ISO)continuous stimulation-induced chronic heart failure(CHF)in mice,providing direct experimental evidence for further clinical applications.In vivo,continuous ISO infusion was administered to mice,and ventricular myocytes were utilized to explore LGZG's potential mechanism of action on theβ1-adrenergic receptor(β1-AR)/Gs/G protein-coupled receptor kinases(GRKs)/β-arrestin signaling deflection system in the heart.The findings reveal that LGZG significantly reduced the messenger ribonucleic acid(mRNA)expression of hypertrophy-related biomarkers[atrial natriuretic peptide(ANP)and B-type natriuretic peptide(BNP)]and improved cardiac remodeling and left ventricular diastolic function in mice with ISO-induced CHF.Furthermore,LGZG inhibited the overactivation of Gs/cyclic adenosine monophosphate(c AMP)/protein kinase A(PKA)signaling and downregulated the downstream transcriptional activity of c AMP-response element binding protein(CREB)and the expression of the coactivator CBP/P300.Notably,LGZG downregulated the expression ofβ-arrestin1 and GRK 2/3/5 while upregulating the expression ofβ1-AR andβ-arrestin2.These results suggest that LGZG inhibits Gs/c AMP/PKA signaling andβ-arrestin/GRK-mediated desensitization and internalization ofβ1-AR,potentially exerting cardioprotective effects through the synergistic regulation of theβ1-AR/Gs/GRKs/β-arrestin signaling deflection system via multiple pathways.
基金Huxiang TCM Physique Intervention Clinical Research Center,No.2023SK4061Traditional Chinese Medicine Research Project of Hunan Province,No.B2023065+4 种基金Hunan Province"14th Five-Year Plan"key specialty of TCM,No.[2023]4Hunan University of Chinese Medicine and Hospital Joint Foundation,No.2023XYLH019 and 2024XYLH365R&D Plan for Key Areas of Hunan Provincial Department of Science and Technology,No.2019SK2321Excellent Youth Program of Hunan Education Department,No.24B0346Hunan Provincial Natural Science Foundation for Young Scientists,No.2025JJ60626.
文摘BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread challenge in the management of CHF.To effectively manage disease progression and alleviate symptoms,it is crucial to identify key influencing factors to facilitate the implementation of targeted interventions.AIM To investigate the status of anxiety and depression among patients with CHF and determine the factors contributing to poor fluid restriction adherence.METHODS Three hundred CHF patients seeking medical treatment at The First Hospital of Hunan University of Traditional Chinese Medicine between June 2021 and June 2023 were included in the study.Questionnaires,including the Psychosomatic Symptom Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and Fluid Restriction Adherence Questionnaire were administered to patients.Based on their anxiety and depression scores,patients were categorized into anxiety/depression and non-anxiety/depression groups,as well as fluid restriction adherence and fluid restriction non-adherence groups.General patient data were collected,and univariate and logistic regression analyses were conducted to determine the occurrence of depression and anxiety.Logistic regression analysis was used to identify independent factors influencing fluid restriction adherence.RESULTS Statistically significant differences in age,New York Heart Association(NYHA)grading,marital status,educational attainment,and family support were observed between depressed and non-depressed CHF patients(P<0.05).Age,NYHA grading,marital status,educational attainment,and family support were identified as factors influencing the development of depression.The anxiety and non-anxiety groups differed statistically in terms of gender,age,NYHA grading,smoking history,alcohol consumption history,monthly income,educational attainment,and family support(P<0.05).Gender,smoking,alcohol consumption,monthly income,and educational attainment affected anxiety in these patients.The fluid restriction adherence rate was 28.0%,and thirst sensation,anxiety,and depression were identified as independent influencing factors.CONCLUSION CHF patients are susceptible to anxiety and depression,with multiple associated influencing factors.Moreover,anxiety and depression are independent factors that can influence fluid restriction adherence in these patients.
基金Supported by Key Research Fund of Wannan Medical College,No.WK2021ZF15Research Foundation for Advanced Talents of Wannan Medical College,No.YR202213+3 种基金Foundation of Anhui Educational Committee,No.2023AH051759Excellent Youth Research Project of Anhui UniversitiesNo.2023AH030107Horizontal Project of Wannan Medical College,No.622202504003 and No.662202404013.
文摘BACKGROUND Research examining the relationships among anxiety,depression,self-perceived burden(SPB),and psychological resilience(PR),along with the determinants of PR,in patients with chronic renal failure(CRF)receiving maintenance hemodia-lysis(MHD)is limited.AIM To investigate the correlation between anxiety,depression,SPB,and PR in pati-ents with CRF on MHD.METHODS This study included 225 patients with CRF on MHD who were admitted between June 2021 and June 2024.The anxiety level was evaluated using the Self-Rating Anxiety Scale(SAS);the depression status was assessed using the Self-Rating Depression Scale(SDS);the SPB was measured using the SPB Scale(SPBS);and the PR was determined using the Connor–Davidson Resilience Scale(CD-RISC).The correlations among the SAS,SDS,SPB,and CD-RISC were analyzed using Pearson’s correlation coefficients.Univariate and multivariate analyses were performed to identify the factors that influence the PR of patients with CRF on MHD.RESULTS The SAS,SDS,SPB,and CD-RISC scores of the 225 patients were 45.25±15.36,54.81±14.68,32.31±11.52,and 66.48±9.18,respectively.Significant negative correlations were observed between SAS,SDS,SPB,and CD-RISC.Furthermore,longer dialysis vintage(P=0.015),the absence of religious beliefs(P=0.020),lower monthly income(P=0.008),higher SAS score(P=0.013),and higher SDS score(P=0.006)were all independent factors that adversely affected the PR of patients with CRF on MHD.CONCLUSION Patients with CRF on MHD present with varying degrees of anxiety,depression,and SPB,all of which exhibit a significant negative correlation with their PR.Moreover,longer dialysis vintage,the absence of religious beliefs,lower monthly income,higher SAS score,and higher SDS score were factors that negatively affected the PR of patients with CRF on MHD.
