According to the requirements of the live-virtual-constructive(LVC)tactical confrontation(TC)on the virtual entity(VE)decision model of graded combat capability,diversified actions,real-time decision-making,and genera...According to the requirements of the live-virtual-constructive(LVC)tactical confrontation(TC)on the virtual entity(VE)decision model of graded combat capability,diversified actions,real-time decision-making,and generalization for the enemy,the confrontation process is modeled as a zero-sum stochastic game(ZSG).By introducing the theory of dynamic relative power potential field,the problem of reward sparsity in the model can be solved.By reward shaping,the problem of credit assignment between agents can be solved.Based on the idea of meta-learning,an extensible multi-agent deep reinforcement learning(EMADRL)framework and solving method is proposed to improve the effectiveness and efficiency of model solving.Experiments show that the model meets the requirements well and the algorithm learning efficiency is high.展开更多
Objective To compare the blood antioxidant levels and dietary antioxidant intakes between pilots and non-flight staff of the Army Force in The Islamic Republic of Iran. Methods Thirty-seven helicopter pilots and 40 no...Objective To compare the blood antioxidant levels and dietary antioxidant intakes between pilots and non-flight staff of the Army Force in The Islamic Republic of Iran. Methods Thirty-seven helicopter pilots and 40 non-flight staff were included in this study. Their general characteristics were recorded and their weight, height, and waist circumference were measured. Their daily intake of energy and nutrients including antioxidants was assessed using a semi-quantitative food frequency questionnaire. Serum levels of total antioxidant capacity （TAC）, malondialdehyde （MDA）, and glutathione reductase （GR）, glutathione peroxidase （GPx）, superoxide dismutase （SOD）, and catalase （CAT） in red blood cells were also measured. Results The median erythrocytes SOD, serum MDA level and the mean serum level of TAC and erythrocytes GPx were significantly higher in pilots than in non-flight staff. The median vitamin C intake was significantly lower in pilots than in non-flight staff. The serum MDA levels were similar in non-flight staff and pilots when their vitamin C intake was 〈168 mg and significantly lower in non-flight staff than in pilots when their vitamin C intake was 〉168 mg. Conclusion The serum MDA level is lower in non-flight staff than in pilots when their vitamin C intake level is high, indicating that pilots need more vitamin C than non-flight staff.展开更多
Background: Malaria infestation in pregnancy is a major public health concern and ranks amongst the commonest complications of pregnancy in Nigeria. Approximately 50,000 Nigerian women die each year from largely preve...Background: Malaria infestation in pregnancy is a major public health concern and ranks amongst the commonest complications of pregnancy in Nigeria. Approximately 50,000 Nigerian women die each year from largely preventable pregnancy related complications. Intermittent preventive therapy for malaria in pregnancy (IPTp) is a key recommendation in the National guideline for malaria treatment in Nigeria. This study assessed the prescription pattern of intermittent preventive therapy with Sulphadoxine-Pyrimethamine for pregnant women among doctors practicing in 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria. Methods: This was a retrospective study using case notes of pregnant women seen at antenatal clinic of 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria from January, 2008 to December, 2008. A total of 336 case notes were reviewed. The findings were precoded, data entry and analysis was done using EPI INFO 2002. Results: A good proportion of the women (82.9%) booked for antenatal clinic within the first and second trimesters of pregnancy. Most commonly prescribed by doctors was the weekly pyrimethamine (daraprim) for malaria prophylaxis in pregnancy (100.0%). Very few doctors prescribed intermittent preventive therapy with sulfadoxine-pyrimethamine, and the few who did prescribed just one dose. Conclusion: The study showed a very low level of prescription of IPTp among doctors practicing at 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria. There is a great need for training of these doctors and other health professionals on the recommendations of the current National Antimalarial Treatment Guidelines.展开更多
Introduction: Human malaria infection remains a problem of public health importance in many regions of the world. The infection continues to spread particularly in sub-Saharan Africa. In Nigeria, malaria and its treat...Introduction: Human malaria infection remains a problem of public health importance in many regions of the world. The infection continues to spread particularly in sub-Saharan Africa. In Nigeria, malaria and its treatment have been affected by factors like wrong diagnosis, wrong attitude of the people, unavailability of drugs, fake and substandard drugs, attitude and practices of medical and paramedical personnel. Nigeria’s national standard for malaria treatment was recently changed to artemisinin combination therapy. Methods: A descriptive study using a structured questionnaire was administered to all doctors (123) practicing in the three Army hospitals in Lagos. The study was done between March, 2009 and April, 2009. The findings were precoded;data entry and analysis was done using EPI INFO version 3.5.1 statistical software. Results: Presumptive/clinical diagnosis was still a common practice for diagnosing malaria among doctors, as well as the use of microscopy. None of the doctors had the facility for diagnosing malaria with rapid diagnostic test in their hospitals. Fifty one percent of the doctors stated that they utilized the current National antimalarial treatment guidelines. Significant proportion of the doctors used Artemisinin-based Combination Therapy (ACTs) as first line treatment of uncomplicated malaria in adults and children. Chloroquine was the commonest drug for first line treatment of uncomplicated malaria in pregnancy. Only 45.5% of the doctors had correct knowledge of Intermittent Preventive Treatment in pregnancy (IPTp), while 33.3% knew the stage of pregnancy in which a pregnant woman should receive IPTp with sulphadoxine-pyrimethamine. Awareness and the content of knowledge of the current National antimalarial treatment guideline were not affected by the category or current position of the doctors. Thirteen percent of the respondents had attended training/update workshop organized by the Federal Ministry of Health (FMOH) Roll Back Malaria programme on the current National antimalarial treatment guideline. Conclusion: The study showed that there is need to improve use of recommended antimalarial medicines for all categories of patients by doctors in Army Hospitals in Lagos. More effort should be made by the Federal Ministry of Health and other stakeholders to organize training and refresher courses on the current National antimalarial treatment guidelines for all categories of health care providers.展开更多
The accurate assessment and diagnosis of combat injuries are the basis for triage and treatment of combat casualties. A consensus on the assessment and diagnosis of combat injuries was made and discussed at the second...The accurate assessment and diagnosis of combat injuries are the basis for triage and treatment of combat casualties. A consensus on the assessment and diagnosis of combat injuries was made and discussed at the second annual meeting of the Professional Committee on Disaster Medicine of the Chinese People's Liberation Army(PLA). In this consensus agreement, the massive hemorrhage, airway, respiration, circulation and hypothermia(MARCH) algorithm, which is a simple triage and rapid treatment and field triage score, was recommended to assess combat casualties during the first-aid stage, whereas the abbreviated scoring method for combat casualty and the MARCH algorithm were recommended to assess combat casualties in level Ⅱ facilities. In level Ⅲ facilities, combined measures, including a history inquiry, thorough physical examination, laboratory examination, X-ray, and ultrasound examination, were recommended for the diagnosis of combat casualties. In addition, corresponding methods were recommended for the recognition of casualties needing massive transfusions, assessment of firearm wounds, evaluation of mangled extremities, and assessment of injury severity in this consensus.展开更多
After inpatient aircrews of Chinese Army and Air Force are treated at local hospitals, their health status will be evaluated. If it is aeronautically adaptable, the conclusion would be flying qualification; if it may ...After inpatient aircrews of Chinese Army and Air Force are treated at local hospitals, their health status will be evaluated. If it is aeronautically adaptable, the conclusion would be flying qualification; if it may impact the flight safety or the flight environment may aggravate展开更多
Background:Incidence and risk factors of parachute injuries has been studied in developed countries,but not in trainees of the airborne forces in the Royal Thailand Army.Methods:A prospective cohort study was conducte...Background:Incidence and risk factors of parachute injuries has been studied in developed countries,but not in trainees of the airborne forces in the Royal Thailand Army.Methods:A prospective cohort study was conducted among 992 military personnel who attended the basic airborne training program from February to July 2018.Information sheets were used to collect data about(a)personal demographics;(b)environmental conditions surrounding the parachute practice;and(c)parachute-related injuries.The incidence rate of injury was then calculated.Risk factors were examined using multilevel Poisson regression analysis and presented as incidence rate ratio(IRR)and 95%confidence interval(95%CI).Results:A total of 166 parachute-related injuries occurred in 4677 jumps.The incidence rate of injury was 35.50 per 1000 jumps(95%CI 30.04–41.21).Factors significantly related to parachute injury included:jumping with equipment versus without equipment[adjusted IRR(95%CI):1.28(0.88–1.87)],higher wind speed[1.54(1.27–1.87)per knot],airplane versus helicopter exit[1.75(0.68–4.55)],side versus rear exit[2.13(1.43–3.23)],night versus day jumping[2.19(0.81–5.90)],and presence of motion sickness[3.43(1.93–6.92)].Conclusions:To prevent military static line parachute injuries,the following factors should be taken into consideration:type of aircraft,aircraft exit,time of the day,equipment,motion sickness and wind speed.Trial registration:The project was certified by the Research Ethics Committee,Faculty of Medicine,Chulalongkorn University(IRB No.697/60).展开更多
Background:The impact of sleep disorders on active-duty soldiers’medical readiness is not currently quantified.Patient data generated at military treatment facilities can be accessed to create research reports and th...Background:The impact of sleep disorders on active-duty soldiers’medical readiness is not currently quantified.Patient data generated at military treatment facilities can be accessed to create research reports and thus can be used to estimate the prevalence of sleep disturbances and the role of sleep on overall health in service members.The current study aimed to quantify sleep-related health issues and their impact on health and nondeployability through the analysis of U.S.military healthcare records from fiscal year 2018(FY2018).Methods:Medical diagnosis information and deployability profiles(e-Profiles)were queried for all active-duty U.S.Army patients with a concurrent sleep disorder diagnosis receiving medical care within FY2018.Nondeployability was predicted from medical reasons for having an e-Profile(categorized as sleep,behavioral health,musculoskeletal,cardiometabolic,injury,or accident)using binomial logistic regression.Sleep e-Profiles were investigated as a moderator between other e-Profile categories and nondeployability.Results:Out of 582,031 soldiers,48.4%(n=281,738)had a sleep-related diagnosis in their healthcare records,9.7%(n=56,247)of soldiers had e-Profiles,and 1.9%(n=10,885)had a sleep e-Profile.Soldiers with sleep e-Profiles were more likely to have had a motor vehicle accident(p OR(prevalence odds ratio)=4.7,95%CI 2.63–8.39,P≤0.001)or work/duty-related injury(p OR=1.6,95%CI 1.32–1.94,P≤0.001).The likelihood of nondeployability was greater in soldiers with a sleep e-Profile and a musculoskeletal e-Profile(p OR=4.25,95%CI 3.75–4.81,P≤0.001)or work/dutyrelated injury(p OR=2.62,95%CI 1.63–4.21,P≤0.001).Conclusion:Nearly half of soldiers had a sleep disorder or sleep-related medical diagnosis in 2018,but their sleep problems are largely not profiled as limitations to medical readiness.Musculoskeletal issues and physical injury predict nondeployability,and nondeployability is more likely to occur in soldiers who have sleep e-Profiles in addition to these issues.Addressing sleep problems may prevent accidents and injuries that could render a soldier nondeployable.展开更多
Background: The Walter Reed Army Institute of Research(WRAIR) Operational Research Kit-Actigraphy(WORK-A) is a set of unique practice parameters and actigraphy-derived measures for the analysis of operational military...Background: The Walter Reed Army Institute of Research(WRAIR) Operational Research Kit-Actigraphy(WORK-A) is a set of unique practice parameters and actigraphy-derived measures for the analysis of operational military sleep patterns. The WORK-A draws on best practices from the literature and comprises 15 additional descriptive variables. Here, we demonstrate the WORK-A with a sample of United States Army Reserve Officers’ Training Corps(ROTC) cadets(n=286) during a month-long capstone pre-commissioning training exercise.Methods: The sleep of ROTC cadets(n=286) was measured by Philips Actiwatch devices during the 31-day training exercise. The preliminary effectiveness of the WORK-A was tested by comparing differences in sleep measures collected by Actiwatches as calculated by Philips Actiware software against WORK-A-determined sleep measures and self-report sleep collected from a subset of ROTC cadets(n=140).Results: Actiware sleep summary statistics were significantly different from WORK-A measures and self-report sleep(P≤0.001). Bedtimes and waketimes as determined by WORK-A major sleep intervals showed the best agreement with self-report bedtime(22:21±1:30 vs. 22:13±0:40, P=0.21) and waketime(04:30±2:17 vs. 04:31±0:47, P=0.68). Though still significantly different, the discrepancy was smaller between the WORK-A measure of time in bed(TIB) for major sleep intervals(352±29) min and self-report nightly sleep duration [(337±57) min, P=0.006] than that between the WORK-A major TIB and Actiware TIB [(177±42) min, P≤0.001].Conclusions: Default actigraphy methods are not the most accurate methods for characterizing soldier sleep, but reliable methods for characterizing operational sleep patterns is a necessary first step in developing strategies to improve soldier readiness. The WORK-A addresses this knowledge gap by providing practice parameters and a robust variety of measures with which to profile sleep behavior in service members.展开更多
Background:Historically,sexually transmitted infections have affected the health of the U.S.military.To determine whether gonorrhea,bacterial vaginosis,genital herpes,and trichomoniasis are predictors of repeat chlamy...Background:Historically,sexually transmitted infections have affected the health of the U.S.military.To determine whether gonorrhea,bacterial vaginosis,genital herpes,and trichomoniasis are predictors of repeat chlamydia diagnoses among U.S.Army women,medical data reported into the Defense Medical Surveillance System during the 2006–2012 period were analyzed.Methods:For all inpatient and outpatient medical records,the first and second International Classification of Diseases,version 9(ICD-9)diagnostic positions were reviewed for each chlamydia case to determine the occurrence of repeat diagnoses.The Andersen-Gill regression model,an extension of the Cox model for multiple failure-time data,was used to study associations between predictors and repeat chlamydia diagnoses.Results:Among 28,201 women with a first chlamydia diagnosis,5145(18.2%),1163(4.1%),267(0.9%),and 88(0.3%)had one,two,three,and four or more repeat diagnoses,respectively.Overall,the incidence of repeat chlamydia was8.31 cases per 100 person-years,with a median follow-up time of 3.39 years.Gonorrhea(hazard ratio(HR)=1.58,95%CI:1.44–1.73)and bacterial vaginosis(HR=1.40,95%CI:1.09–1.79)were significant predictors for repeat chlamydia.These estimated hazard ratios were attenuated,but remained significant,after controlling for age,race/ethnicity,marital status,and military rank.No significant association was found for genital herpes(HR=1.13,95%CI:0.55–2.29)and trichomoniasis(HR=1.43,95%CI:0.43–4.68).Conclusions:This large cohort study suggests that gonorrhea and bacterial vaginosis were associated with repeat chlamydia diagnoses among U.S.Army women.These findings can be used in formulating new interventions to prevent repeat chlamydia diagnoses.展开更多
Background: In Nigeria, adolescents and young people (AYP) aged 10 - 24, comprise 22.3% of the population and with HIV prevalence of 3.5%. The AYP living with HIV enrolled at the 68 NARHY, Lagos reflects the national ...Background: In Nigeria, adolescents and young people (AYP) aged 10 - 24, comprise 22.3% of the population and with HIV prevalence of 3.5%. The AYP living with HIV enrolled at the 68 NARHY, Lagos reflects the national challenges with poor viral suppression. The OTZ program aligns with the UNAIDS 95-95-95 goals. It seeks to empower AYPLHIV to be in charge of their treatment and commit to triple zero outcomeszero missed appointments, zero missed drugs, and zero viral loads. The purpose of the study was to assess the impact of the OTZ program on viral load suppression among members of the adolescent club in 68 NARHY, Lagos. Method: A cross-sectional retrospective study to evaluate the impact of the OTZ program on the viral load of 53 AYP enrolled in the OTZ program between March 2019 to December 2019 was analyzed. The Percentage of viral load suppression before enrollment compared with 6 and 12 months after enrollment into the OTZ program. The AYP is grouped into 10 - 14, 15 - 19, and 20 - 24 years. Activities conducted were peer driven monthly meetings with the AYP during which the adolescents interacted on issues relating to improving their treatment outcomes, healthcare workers reviewed their clinical status, viral load result, provider peer counseling, and caregivers engagement to support adherence to medication and ARV refills. Results: Before OTZ, 81% aged 10 - 14 years, 75% aged 15 - 19 years, and 25% aged 20 - 24 years were virally suppressed (VL less than 1000 copies/ml). Six months after enrollment, 94% were virally suppressed95% aged 10 - 14 years, 96% aged 15 - 19 years, and 66% aged 20-24 years. Twelve months after enrollment, 96% of AYP were virally suppressed100% aged 10-14 years, 93% aged 15 - 19 years, and 100% aged 20 - 24 years. Males viral load (VL) suppression improved from 79% to 96% and 92%, while females VL suppression improved from 69% to 93% and 100% at 6 and 12 months respectively. Conclusion: The OTZ activities contributed to improved viral load suppression in the AYP of the facility.展开更多
Background: The non-communicable diseases (NCDs) have become a public health priority. The objectives of this study were to measure the prevalence and to assess the risk factors of NCDs among the Senegalese military p...Background: The non-communicable diseases (NCDs) have become a public health priority. The objectives of this study were to measure the prevalence and to assess the risk factors of NCDs among the Senegalese military population to initiate an intervention program. Methods: A cross-sectional survey was conducted in 2014. Two-level stratification was used to sample participants. Data were collected following the protocol recommended by the World Health Organization. Data were managed using Epi-Info 6 software and analyzed using R software. Results: A total of 1224 participants were recruited, of whom 96.9% were men. Their ages ranged from 25 to 60 years with a mean of 39.7 ± 9.2 years. Of participants, 17.2% were active smokers. Average duration of active smoking was 19.9 ± 9 years. The prevalence of current alcohol consumption was 11.5%, with an average of 4 ± 2.7 glasses a day. 97.17% of participants consumed fewer than 5 servings of fruits and vegetables a day. 18.63% had insufficient physical activity. The overall prevalence of high blood pressure was 26.9%. The proportion of those who were overweight was 27.2%;3.3% were obese. 3.0% of participants had diabetes and 44.1% had hypercholesterolemia. After adjusting for waist circumference, the risk of high cholesterol was 2.42 in the 35 - 44 age group and 2.86 in the 45 - 60 age group in comparison with the 25 - 34 age group. 32% were classified as having stage 2 chronic kidney. Conclusions: The findings of this study indicate the importance of risk factors for NCDs in the Senegalese military population. Intervention based on prevention and health promotion is needed.展开更多
Platinum group metals have high melting points,strong corrosion resistance,stable chemical properties,and low oxygen permeability in high-temperature oxygen-containing environments.As thermal protective coating materi...Platinum group metals have high melting points,strong corrosion resistance,stable chemical properties,and low oxygen permeability in high-temperature oxygen-containing environments.As thermal protective coating materials,they have gained essential applications in the aerospace field and have excellent prospects for application in frontier military fields,such as protecting hot-end components of hypersonic aircraft.This research reviewed the latest research progress of platinum group metal coatings with hightemperature oxidation resistance,including coating preparation techniques,oxidation failure,and alloying modification.The leading preparation techniques of current platinum group metal coatings were discussed,as well as the advantages and disadvantages of various existing preparation techniques.Besides,the intrinsic properties,failure forms,and failure mechanisms of coatings of single platinum group metal in high-temperature oxygen-containing environments were analyzed.On this basis,the necessity,main methods,and main achievements of alloying modification of platinum group metals were summarized.Finally,the future development of platinum group coatings with high-temperature oxidation resistance was discussed and prospected.展开更多
Effective treatment methods for stroke,a common cerebrovascular disease with a high mortality rate,are still being sought.Exosome therapy,a form of acellular therapy,has demonstrated promising efficacy in various dise...Effective treatment methods for stroke,a common cerebrovascular disease with a high mortality rate,are still being sought.Exosome therapy,a form of acellular therapy,has demonstrated promising efficacy in various diseases in animal models;however,there is currently insufficient evidence to guide the clinical application of exosome in patients with stroke.This article reviews the progress of exosome applications in stroke treatment.It aims to elucidate the significant potential value of exosomes in stroke therapy and provide a reference for their clinical translation.At present,many studies on exosome-based therapies for stroke are actively underway.Regarding preclinical research,exosomes,as bioactive substances with diverse sources,currently favor stem cells as their origin.Due to their high plasticity,exosomes can be effectively modified through various physical,chemical,and genetic engineering methods to enhance their efficacy.In animal models of stroke,exosome therapy can reduce neuroinflammatory responses,alleviate oxidative stress damage,and inhibit programmed cell death.Additionally,exosomes can promote angiogenesis,repair and regenerate damaged white matter fiber bundles,and facilitate the migration and differentiation of neural stem cells,aiding the repair process.We also summarize new directions for the application of exosomes,specifically the exosome intervention through the ventricular-meningeal lymphatic system.The review findings suggest that the treatment paradigm for stroke is poised for transformation.展开更多
BACKGROUND Due to the dry and cold climate,the obvious temperature difference between day and night,and the low oxygen content of the air in the plateau area,people are prone to upper respiratory tract diseases,and of...BACKGROUND Due to the dry and cold climate,the obvious temperature difference between day and night,and the low oxygen content of the air in the plateau area,people are prone to upper respiratory tract diseases,and often the condition is prolonged,and the patients are prone to anxiety and uneasiness,which may be related to the harshness of the plateau environment,somatic discomfort due to the lack of oxygen,anxiety about the disease,and other factors.AIM To investigate the effects of cognitive behavioral therapy(CBT)on anxiety,sleep disorders,and hypoxia tolerance in patients with high-altitude respiratory diseases.METHODS A total of 2337 patients with high-altitude-related respiratory diseases treated at our hospital between November 2023 and January 2024 were selected as the study subjects.The subjects’pre-high-altitude residential altitude was approximately 1700 meters.They were divided into two groups.Both groups were given symptomatic treatment,and the control group implemented conventional nursing intervention,while the research group simultaneously conducted CBT intervention;assessed the degree of health knowledge of the two groups,and applied the Hamilton Anxiety Scale and the Pittsburgh Sleep Quality Index to assess the anxiety and sleep quality of the patients before and after the intervention,respectively.It also observed the length and efficiency of sleep,and detected the level of serum hypoxia inducible factor-1α,erythropoietin(EPO)and clinical intervention before and after intervention.EPO levels,and investigated satisfaction with the clinical intervention.RESULTS The rate of excellent health knowledge in the intervention group was 93.64%,which was higher than that in the control group(74.23%;P<0.05).Before the intervention,there was no significant difference in Hamilton Anxiety Scale and Pittsburgh Sleep Quality Index scores between the two groups(P>0.05),and after the intervention,the scores of the study group were significantly lower than those of the control group(P<0.05).There was no significant difference in sleep duration and sleep efficiency between the groups before the intervention(P>0.05),and after the intervention,the scores of the study group were significantly larger than those of the control group(P<0.05).There was no significant difference in serum hypoxia inducible factor-1αand EPO between the two groups before intervention(P>0.05),and both research groups were significantly lower than the control group after intervention(P<0.05).According to the questionnaire survey,the intervention satisfaction of the study group was 95.53%,which was higher than that of the control group(80.14%;P<0.05).CONCLUSION The CBT intervention in the treatment of patients with high-altitude-related respiratory diseases helps improve patients'health knowledge,relieve anxiety,improve sleep quality and hypoxia tolerance,and improve nursing satisfaction.展开更多
Our previous study demonstrated that combined transplantation of bone marrow mesenchymal stem cells and retinal progenitor cells in rats has therapeutic effects on retinal degeneration that are superior to transplanta...Our previous study demonstrated that combined transplantation of bone marrow mesenchymal stem cells and retinal progenitor cells in rats has therapeutic effects on retinal degeneration that are superior to transplantation of retinal progenitor cells alone.Bone marrow mesenchymal stem cells regulate and interact with various cells in the retinal microenvironment by secreting neurotrophic factors and extracellular vesicles.Small extracellular vesicles derived from bone marrow mesenchymal stem cells,which offer low immunogenicity,minimal tumorigenic risk,and ease of transportation,have been utilized in the treatment of various neurological diseases.These vesicles exhibit various activities,including anti-inflammatory actions,promotion of tissue repair,and immune regulation.Therefore,novel strategies using human retinal progenitor cells combined with bone marrow mesenchymal stem cell-derived small extracellular vesicles may represent an innovation in stem cell therapy for retinal degeneration.In this study,we developed such an approach utilizing retinal progenitor cells combined with bone marrow mesenchymal stem cell-derived small extracellular vesicles to treat retinal degeneration in Royal College of Surgeons rats,a genetic model of retinal degeneration.Our findings revealed that the combination of bone marrow mesenchymal stem cell-derived small extracellular vesicles and retinal progenitor cells significantly improved visual function in these rats.The addition of bone marrow mesenchymal stem cell-derived small extracellular vesicles as adjuvants to stem cell transplantation with retinal progenitor cells enhanced the survival,migration,and differentiation of the exogenous retinal progenitor cells.Concurrently,these small extracellular vesicles inhibited the activation of regional microglia,promoted the migration of transplanted retinal progenitor cells to the inner nuclear layer of the retina,and facilitated their differentiation into photoreceptors and bipolar cells.These findings suggest that bone marrow mesenchymal stem cell-derived small extracellular vesicles potentiate the therapeutic efficacy of retinal progenitor cells in retinal degeneration by promoting their survival and differentiation.展开更多
Background:Lumbar disc degeneration(LDD)displays considerable heterogeneity in terms of clinical features and pathological changes.However,researchers have not clearly determined whether the transcriptome variations i...Background:Lumbar disc degeneration(LDD)displays considerable heterogeneity in terms of clinical features and pathological changes.However,researchers have not clearly determined whether the transcriptome variations in LDD could be used to identify or interpret the causes of heterogeneity in clinical features.This study aimed to identify the transcriptomic classification of degenerated discs in LDD patients and whether the molecular subtypes of LDD could be accurately predicted using clinical features.Methods:One hundred and twenty-two nucleus pulposus(NP)tissues from 108 patients were consecutively collected for bulk RNA sequencing(RNA-seq).An unsupervised clustering method was employed to analyze the bulk RNA matrix.Differential analysis was performed to characterize the transcriptional signatures and subtype-specific extracellular matrix(ECM)dysregulation.The cell subpopulation states of each subtype were inferred by integrating bulk and single-cell sequencing datasets.Transwell and dual-luciferase reporter gene assays were employed to investigate possible molecular mechanisms involved.Machine learning algorithm diagnostic prediction models were developed to correlate molecular classification with clinical features.Results:LDD was classified into 4 subtypes with distinct molecular signatures and ECM remodeling:C1 with collagenesis,C2 with ossification,C3 with low chondrogenesis,and C4 with fibrogenesis.Chond1-3 in C1 dominated disc collagenesis via the activation of the mechanosensors TRPV4 and PIEZO1;NP progenitor cells in C2 exhibited chondrogenic and osteogenic phenotypes;Chond1 in C3 was linked to a disrupted hypoxic microenvironment leading to reduced chondrogenesis;Macrophages in C4 played a crucial role in disc fibrogenesis via the secretion of tumor necrosis factor-α(TNF-α).Furthermore,the random forest diagnostic prediction model was proven to have a robust performance[area under the receiver operating characteristic(ROC)curve:0.9312;accuracy:0.84]in stratifying the molecular subtypes of LDD based on 12 clinical features.Conclusions:Our study delineates 4 distinct molecular subtypes of LDD that can be accurately stratified on the basis of clinical features.The identification of these subtypes would facilitate precise diagnostics and guide the development of personalized treatment strategies for LDD.展开更多
BACKGROUND Perimenopausal women are prone to anxiety and depression due to fluctuating hormone levels,which significantly impair their quality of life.The current treatments have certain limitations.In traditional Chi...BACKGROUND Perimenopausal women are prone to anxiety and depression due to fluctuating hormone levels,which significantly impair their quality of life.The current treatments have certain limitations.In traditional Chinese medicine,liver-soothing formulas are commonly prescribed for mood-related disorders,but their overall efficacy in perimenopausal anxiety and depression remains uncertain and requires verification through meta-analysis.AIM To provide evidence-based support for clinical decision-making and research,a meta-analysis was conducted to evaluate the effectiveness of liver-soothing formulas in treating perimenopausal anxiety and depression.METHODS Relevant studies published up to April 2025 were retrieved from ClinicalTrials.gov,PubMed,Web of Science,EMBASE,and the Cochrane Library.Eligible studies were screened according to predefined inclusion and exclusion criteria.Data were extracted and analyzed using the Stata 12.0 software.RESULTS After searching and screening,12 articles involving 1798 patients(922 in the treatment group and 876 in the control group)were included in the analysis.Meta-analysis showed that the standardized scores for anxiety[standardized mean difference(SMD)=-0.71,95%confidence interval(95%CI):-1.06 to-0.36]and depression(SMD=-0.67,95%CI:-1.06 to-0.27)of the treatment group were lower than those of the control group.Subgroup analysis results revealed that for anxiety,liver-soothing formulas used alone(SMD=-0.34,95%CI:-0.50 to-0.18)or in combination(SMD=-0.88,95%CI:-1.43 to-0.34)both significantly reduced scores compared with the control group.For depression,monotherapy of liversoothing formulas showed no significant statistical difference between the treatment and control groups(SMD=-0.47,95%CI:-1.11 to 0.17),whereas combination therapy produced significantly lower standardized scale scores in the treatment group than in the control group,with a statistically significant difference(SMD=-0.83,95%CI:-1.39 to-0.28).Regarding Greene scores,no statistically significant difference was observed with monotherapy(SMD=0.87,95%CI:-0.32 to 2.06),whereas combination therapy had significantly lower Greene scores(SMD=-0.24,95%CI:-0.44 to-0.04).No statistically significant difference was found between the groups in the occurrence of adverse reactions(odds ratio=0.90,95%CI:0.57-1.43).However,liver-soothing formulas did not affect estrogen levels in perimenopausal women.CONCLUSION Compared with placebo,conventional Western medicine,or other interventions,the monotherapy of liver-soothing formulas demonstrates superior efficacy in treating perimenopausal anxiety.When used as an adjuvant,they exert a synergistic effect in alleviating negative emotions and improving overall perimenopausal symptoms.展开更多
Rheumatoid arthritis(RA)patients face significant psychological challenges alongside physical symptoms,necessitating a comprehensive understanding of how psychological vulnerability and adaptation patterns evolve thro...Rheumatoid arthritis(RA)patients face significant psychological challenges alongside physical symptoms,necessitating a comprehensive understanding of how psychological vulnerability and adaptation patterns evolve throughout the disease course.This review examined 95 studies(2000-2025)from PubMed,Web of Science,and CNKI databases including longitudinal cohorts,randomized controlled trials,and mixed-methods research,to characterize the complex interplay between biological,psychological,and social factors affecting RA patients’mental health.Findings revealed three distinct vulnerability trajectories(45%persistently low,30%fluctuating improvement,25%persistently high)and four adaptation stages,with critical intervention periods occurring 3-6 months postdiagnosis and during disease flares.Multiple factors significantly influence psychological outcomes,including gender(females showing 1.8-fold increased risk),age(younger patients experiencing 42%higher vulnerability),pain intensity,inflammatory markers,and neuroendocrine dysregulation(48%showing cortisol rhythm disruption).Early psychological intervention(within 3 months of diagnosis)demonstrated robust benefits,reducing depression incidence by 42%with effects persisting 24-36 months,while different modalities showed complementary advantages:Cognitive behavioral therapy for depression(Cohen’s d=0.68),mindfulness for pain acceptance(38%improvement),and peer support for meaning reconstruction(25.6%increase).These findings underscore the importance of integrating routine psychological assessment into standard RA care,developing stage-appropriate interventions,and advancing research toward personalized biopsychosocial approaches that address the dynamic psychological dimensions of the disease.展开更多
Accurate prediction of remaining useful life serves as a reliable basis for maintenance strategies,effectively reducing both the frequency of failures and associated costs.As a core component of PHM,RUL prediction pla...Accurate prediction of remaining useful life serves as a reliable basis for maintenance strategies,effectively reducing both the frequency of failures and associated costs.As a core component of PHM,RUL prediction plays a crucial role in preventing equipment failures and optimizing maintenance decision-making.However,deep learning models often falter when processing raw,noisy temporal signals,fail to quantify prediction uncertainty,and face challenges in effectively capturing the nonlinear dynamics of equipment degradation.To address these issues,this study proposes a novel deep learning framework.First,a newbidirectional long short-termmemory network integrated with an attention mechanism is designed to enhance temporal feature extraction with improved noise robustness.Second,a probabilistic prediction framework based on kernel density estimation is constructed,incorporating residual connections and stochastic regularization to achieve precise RUL estimation.Finally,extensive experiments on the C-MAPSS dataset demonstrate that our method achieves competitive performance in terms of RMSE and Score metrics compared to state-of-the-artmodels.More importantly,the probabilistic output provides a quantifiablemeasure of prediction confidence,which is crucial for risk-informed maintenance planning,enabling managers to optimize maintenance strategies based on a quantifiable understanding of failure risk.展开更多
基金supported by the Military Scentific Research Project(41405030302,41401020301).
文摘According to the requirements of the live-virtual-constructive(LVC)tactical confrontation(TC)on the virtual entity(VE)decision model of graded combat capability,diversified actions,real-time decision-making,and generalization for the enemy,the confrontation process is modeled as a zero-sum stochastic game(ZSG).By introducing the theory of dynamic relative power potential field,the problem of reward sparsity in the model can be solved.By reward shaping,the problem of credit assignment between agents can be solved.Based on the idea of meta-learning,an extensible multi-agent deep reinforcement learning(EMADRL)framework and solving method is proposed to improve the effectiveness and efficiency of model solving.Experiments show that the model meets the requirements well and the algorithm learning efficiency is high.
基金funded by the Medical University of Armed Forces
文摘Objective To compare the blood antioxidant levels and dietary antioxidant intakes between pilots and non-flight staff of the Army Force in The Islamic Republic of Iran. Methods Thirty-seven helicopter pilots and 40 non-flight staff were included in this study. Their general characteristics were recorded and their weight, height, and waist circumference were measured. Their daily intake of energy and nutrients including antioxidants was assessed using a semi-quantitative food frequency questionnaire. Serum levels of total antioxidant capacity （TAC）, malondialdehyde （MDA）, and glutathione reductase （GR）, glutathione peroxidase （GPx）, superoxide dismutase （SOD）, and catalase （CAT） in red blood cells were also measured. Results The median erythrocytes SOD, serum MDA level and the mean serum level of TAC and erythrocytes GPx were significantly higher in pilots than in non-flight staff. The median vitamin C intake was significantly lower in pilots than in non-flight staff. The serum MDA levels were similar in non-flight staff and pilots when their vitamin C intake was 〈168 mg and significantly lower in non-flight staff than in pilots when their vitamin C intake was 〉168 mg. Conclusion The serum MDA level is lower in non-flight staff than in pilots when their vitamin C intake level is high, indicating that pilots need more vitamin C than non-flight staff.
文摘Background: Malaria infestation in pregnancy is a major public health concern and ranks amongst the commonest complications of pregnancy in Nigeria. Approximately 50,000 Nigerian women die each year from largely preventable pregnancy related complications. Intermittent preventive therapy for malaria in pregnancy (IPTp) is a key recommendation in the National guideline for malaria treatment in Nigeria. This study assessed the prescription pattern of intermittent preventive therapy with Sulphadoxine-Pyrimethamine for pregnant women among doctors practicing in 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria. Methods: This was a retrospective study using case notes of pregnant women seen at antenatal clinic of 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria from January, 2008 to December, 2008. A total of 336 case notes were reviewed. The findings were precoded, data entry and analysis was done using EPI INFO 2002. Results: A good proportion of the women (82.9%) booked for antenatal clinic within the first and second trimesters of pregnancy. Most commonly prescribed by doctors was the weekly pyrimethamine (daraprim) for malaria prophylaxis in pregnancy (100.0%). Very few doctors prescribed intermittent preventive therapy with sulfadoxine-pyrimethamine, and the few who did prescribed just one dose. Conclusion: The study showed a very low level of prescription of IPTp among doctors practicing at 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria. There is a great need for training of these doctors and other health professionals on the recommendations of the current National Antimalarial Treatment Guidelines.
文摘Introduction: Human malaria infection remains a problem of public health importance in many regions of the world. The infection continues to spread particularly in sub-Saharan Africa. In Nigeria, malaria and its treatment have been affected by factors like wrong diagnosis, wrong attitude of the people, unavailability of drugs, fake and substandard drugs, attitude and practices of medical and paramedical personnel. Nigeria’s national standard for malaria treatment was recently changed to artemisinin combination therapy. Methods: A descriptive study using a structured questionnaire was administered to all doctors (123) practicing in the three Army hospitals in Lagos. The study was done between March, 2009 and April, 2009. The findings were precoded;data entry and analysis was done using EPI INFO version 3.5.1 statistical software. Results: Presumptive/clinical diagnosis was still a common practice for diagnosing malaria among doctors, as well as the use of microscopy. None of the doctors had the facility for diagnosing malaria with rapid diagnostic test in their hospitals. Fifty one percent of the doctors stated that they utilized the current National antimalarial treatment guidelines. Significant proportion of the doctors used Artemisinin-based Combination Therapy (ACTs) as first line treatment of uncomplicated malaria in adults and children. Chloroquine was the commonest drug for first line treatment of uncomplicated malaria in pregnancy. Only 45.5% of the doctors had correct knowledge of Intermittent Preventive Treatment in pregnancy (IPTp), while 33.3% knew the stage of pregnancy in which a pregnant woman should receive IPTp with sulphadoxine-pyrimethamine. Awareness and the content of knowledge of the current National antimalarial treatment guideline were not affected by the category or current position of the doctors. Thirteen percent of the respondents had attended training/update workshop organized by the Federal Ministry of Health (FMOH) Roll Back Malaria programme on the current National antimalarial treatment guideline. Conclusion: The study showed that there is need to improve use of recommended antimalarial medicines for all categories of patients by doctors in Army Hospitals in Lagos. More effort should be made by the Federal Ministry of Health and other stakeholders to organize training and refresher courses on the current National antimalarial treatment guidelines for all categories of health care providers.
基金Special Project in Military Logistics Scientific Program during the Twelfth Five-year Plan Period(AWS14L012)Innovation Project of Military Medicine(16CXZ017)
文摘The accurate assessment and diagnosis of combat injuries are the basis for triage and treatment of combat casualties. A consensus on the assessment and diagnosis of combat injuries was made and discussed at the second annual meeting of the Professional Committee on Disaster Medicine of the Chinese People's Liberation Army(PLA). In this consensus agreement, the massive hemorrhage, airway, respiration, circulation and hypothermia(MARCH) algorithm, which is a simple triage and rapid treatment and field triage score, was recommended to assess combat casualties during the first-aid stage, whereas the abbreviated scoring method for combat casualty and the MARCH algorithm were recommended to assess combat casualties in level Ⅱ facilities. In level Ⅲ facilities, combined measures, including a history inquiry, thorough physical examination, laboratory examination, X-ray, and ultrasound examination, were recommended for the diagnosis of combat casualties. In addition, corresponding methods were recommended for the recognition of casualties needing massive transfusions, assessment of firearm wounds, evaluation of mangled extremities, and assessment of injury severity in this consensus.
基金Supported by a grant from the Chinese People’s Liberation Army (04XL022)
文摘After inpatient aircrews of Chinese Army and Air Force are treated at local hospitals, their health status will be evaluated. If it is aeronautically adaptable, the conclusion would be flying qualification; if it may impact the flight safety or the flight environment may aggravate
文摘Background:Incidence and risk factors of parachute injuries has been studied in developed countries,but not in trainees of the airborne forces in the Royal Thailand Army.Methods:A prospective cohort study was conducted among 992 military personnel who attended the basic airborne training program from February to July 2018.Information sheets were used to collect data about(a)personal demographics;(b)environmental conditions surrounding the parachute practice;and(c)parachute-related injuries.The incidence rate of injury was then calculated.Risk factors were examined using multilevel Poisson regression analysis and presented as incidence rate ratio(IRR)and 95%confidence interval(95%CI).Results:A total of 166 parachute-related injuries occurred in 4677 jumps.The incidence rate of injury was 35.50 per 1000 jumps(95%CI 30.04–41.21).Factors significantly related to parachute injury included:jumping with equipment versus without equipment[adjusted IRR(95%CI):1.28(0.88–1.87)],higher wind speed[1.54(1.27–1.87)per knot],airplane versus helicopter exit[1.75(0.68–4.55)],side versus rear exit[2.13(1.43–3.23)],night versus day jumping[2.19(0.81–5.90)],and presence of motion sickness[3.43(1.93–6.92)].Conclusions:To prevent military static line parachute injuries,the following factors should be taken into consideration:type of aircraft,aircraft exit,time of the day,equipment,motion sickness and wind speed.Trial registration:The project was certified by the Research Ethics Committee,Faculty of Medicine,Chulalongkorn University(IRB No.697/60).
基金The Department of Defense Military Operational Medicine Research Program(MOMRP)supported this study。
文摘Background:The impact of sleep disorders on active-duty soldiers’medical readiness is not currently quantified.Patient data generated at military treatment facilities can be accessed to create research reports and thus can be used to estimate the prevalence of sleep disturbances and the role of sleep on overall health in service members.The current study aimed to quantify sleep-related health issues and their impact on health and nondeployability through the analysis of U.S.military healthcare records from fiscal year 2018(FY2018).Methods:Medical diagnosis information and deployability profiles(e-Profiles)were queried for all active-duty U.S.Army patients with a concurrent sleep disorder diagnosis receiving medical care within FY2018.Nondeployability was predicted from medical reasons for having an e-Profile(categorized as sleep,behavioral health,musculoskeletal,cardiometabolic,injury,or accident)using binomial logistic regression.Sleep e-Profiles were investigated as a moderator between other e-Profile categories and nondeployability.Results:Out of 582,031 soldiers,48.4%(n=281,738)had a sleep-related diagnosis in their healthcare records,9.7%(n=56,247)of soldiers had e-Profiles,and 1.9%(n=10,885)had a sleep e-Profile.Soldiers with sleep e-Profiles were more likely to have had a motor vehicle accident(p OR(prevalence odds ratio)=4.7,95%CI 2.63–8.39,P≤0.001)or work/duty-related injury(p OR=1.6,95%CI 1.32–1.94,P≤0.001).The likelihood of nondeployability was greater in soldiers with a sleep e-Profile and a musculoskeletal e-Profile(p OR=4.25,95%CI 3.75–4.81,P≤0.001)or work/dutyrelated injury(p OR=2.62,95%CI 1.63–4.21,P≤0.001).Conclusion:Nearly half of soldiers had a sleep disorder or sleep-related medical diagnosis in 2018,but their sleep problems are largely not profiled as limitations to medical readiness.Musculoskeletal issues and physical injury predict nondeployability,and nondeployability is more likely to occur in soldiers who have sleep e-Profiles in addition to these issues.Addressing sleep problems may prevent accidents and injuries that could render a soldier nondeployable.
基金The Department of Defense Military Operational Medicine Research Program (MOMRP) supported this study。
文摘Background: The Walter Reed Army Institute of Research(WRAIR) Operational Research Kit-Actigraphy(WORK-A) is a set of unique practice parameters and actigraphy-derived measures for the analysis of operational military sleep patterns. The WORK-A draws on best practices from the literature and comprises 15 additional descriptive variables. Here, we demonstrate the WORK-A with a sample of United States Army Reserve Officers’ Training Corps(ROTC) cadets(n=286) during a month-long capstone pre-commissioning training exercise.Methods: The sleep of ROTC cadets(n=286) was measured by Philips Actiwatch devices during the 31-day training exercise. The preliminary effectiveness of the WORK-A was tested by comparing differences in sleep measures collected by Actiwatches as calculated by Philips Actiware software against WORK-A-determined sleep measures and self-report sleep collected from a subset of ROTC cadets(n=140).Results: Actiware sleep summary statistics were significantly different from WORK-A measures and self-report sleep(P≤0.001). Bedtimes and waketimes as determined by WORK-A major sleep intervals showed the best agreement with self-report bedtime(22:21±1:30 vs. 22:13±0:40, P=0.21) and waketime(04:30±2:17 vs. 04:31±0:47, P=0.68). Though still significantly different, the discrepancy was smaller between the WORK-A measure of time in bed(TIB) for major sleep intervals(352±29) min and self-report nightly sleep duration [(337±57) min, P=0.006] than that between the WORK-A major TIB and Actiware TIB [(177±42) min, P≤0.001].Conclusions: Default actigraphy methods are not the most accurate methods for characterizing soldier sleep, but reliable methods for characterizing operational sleep patterns is a necessary first step in developing strategies to improve soldier readiness. The WORK-A addresses this knowledge gap by providing practice parameters and a robust variety of measures with which to profile sleep behavior in service members.
基金funded by the AFHSB and its Global Emerging Infectious Surveillance section
文摘Background:Historically,sexually transmitted infections have affected the health of the U.S.military.To determine whether gonorrhea,bacterial vaginosis,genital herpes,and trichomoniasis are predictors of repeat chlamydia diagnoses among U.S.Army women,medical data reported into the Defense Medical Surveillance System during the 2006–2012 period were analyzed.Methods:For all inpatient and outpatient medical records,the first and second International Classification of Diseases,version 9(ICD-9)diagnostic positions were reviewed for each chlamydia case to determine the occurrence of repeat diagnoses.The Andersen-Gill regression model,an extension of the Cox model for multiple failure-time data,was used to study associations between predictors and repeat chlamydia diagnoses.Results:Among 28,201 women with a first chlamydia diagnosis,5145(18.2%),1163(4.1%),267(0.9%),and 88(0.3%)had one,two,three,and four or more repeat diagnoses,respectively.Overall,the incidence of repeat chlamydia was8.31 cases per 100 person-years,with a median follow-up time of 3.39 years.Gonorrhea(hazard ratio(HR)=1.58,95%CI:1.44–1.73)and bacterial vaginosis(HR=1.40,95%CI:1.09–1.79)were significant predictors for repeat chlamydia.These estimated hazard ratios were attenuated,but remained significant,after controlling for age,race/ethnicity,marital status,and military rank.No significant association was found for genital herpes(HR=1.13,95%CI:0.55–2.29)and trichomoniasis(HR=1.43,95%CI:0.43–4.68).Conclusions:This large cohort study suggests that gonorrhea and bacterial vaginosis were associated with repeat chlamydia diagnoses among U.S.Army women.These findings can be used in formulating new interventions to prevent repeat chlamydia diagnoses.
文摘Background: In Nigeria, adolescents and young people (AYP) aged 10 - 24, comprise 22.3% of the population and with HIV prevalence of 3.5%. The AYP living with HIV enrolled at the 68 NARHY, Lagos reflects the national challenges with poor viral suppression. The OTZ program aligns with the UNAIDS 95-95-95 goals. It seeks to empower AYPLHIV to be in charge of their treatment and commit to triple zero outcomeszero missed appointments, zero missed drugs, and zero viral loads. The purpose of the study was to assess the impact of the OTZ program on viral load suppression among members of the adolescent club in 68 NARHY, Lagos. Method: A cross-sectional retrospective study to evaluate the impact of the OTZ program on the viral load of 53 AYP enrolled in the OTZ program between March 2019 to December 2019 was analyzed. The Percentage of viral load suppression before enrollment compared with 6 and 12 months after enrollment into the OTZ program. The AYP is grouped into 10 - 14, 15 - 19, and 20 - 24 years. Activities conducted were peer driven monthly meetings with the AYP during which the adolescents interacted on issues relating to improving their treatment outcomes, healthcare workers reviewed their clinical status, viral load result, provider peer counseling, and caregivers engagement to support adherence to medication and ARV refills. Results: Before OTZ, 81% aged 10 - 14 years, 75% aged 15 - 19 years, and 25% aged 20 - 24 years were virally suppressed (VL less than 1000 copies/ml). Six months after enrollment, 94% were virally suppressed95% aged 10 - 14 years, 96% aged 15 - 19 years, and 66% aged 20-24 years. Twelve months after enrollment, 96% of AYP were virally suppressed100% aged 10-14 years, 93% aged 15 - 19 years, and 100% aged 20 - 24 years. Males viral load (VL) suppression improved from 79% to 96% and 92%, while females VL suppression improved from 69% to 93% and 100% at 6 and 12 months respectively. Conclusion: The OTZ activities contributed to improved viral load suppression in the AYP of the facility.
文摘Background: The non-communicable diseases (NCDs) have become a public health priority. The objectives of this study were to measure the prevalence and to assess the risk factors of NCDs among the Senegalese military population to initiate an intervention program. Methods: A cross-sectional survey was conducted in 2014. Two-level stratification was used to sample participants. Data were collected following the protocol recommended by the World Health Organization. Data were managed using Epi-Info 6 software and analyzed using R software. Results: A total of 1224 participants were recruited, of whom 96.9% were men. Their ages ranged from 25 to 60 years with a mean of 39.7 ± 9.2 years. Of participants, 17.2% were active smokers. Average duration of active smoking was 19.9 ± 9 years. The prevalence of current alcohol consumption was 11.5%, with an average of 4 ± 2.7 glasses a day. 97.17% of participants consumed fewer than 5 servings of fruits and vegetables a day. 18.63% had insufficient physical activity. The overall prevalence of high blood pressure was 26.9%. The proportion of those who were overweight was 27.2%;3.3% were obese. 3.0% of participants had diabetes and 44.1% had hypercholesterolemia. After adjusting for waist circumference, the risk of high cholesterol was 2.42 in the 35 - 44 age group and 2.86 in the 45 - 60 age group in comparison with the 25 - 34 age group. 32% were classified as having stage 2 chronic kidney. Conclusions: The findings of this study indicate the importance of risk factors for NCDs in the Senegalese military population. Intervention based on prevention and health promotion is needed.
文摘Platinum group metals have high melting points,strong corrosion resistance,stable chemical properties,and low oxygen permeability in high-temperature oxygen-containing environments.As thermal protective coating materials,they have gained essential applications in the aerospace field and have excellent prospects for application in frontier military fields,such as protecting hot-end components of hypersonic aircraft.This research reviewed the latest research progress of platinum group metal coatings with hightemperature oxidation resistance,including coating preparation techniques,oxidation failure,and alloying modification.The leading preparation techniques of current platinum group metal coatings were discussed,as well as the advantages and disadvantages of various existing preparation techniques.Besides,the intrinsic properties,failure forms,and failure mechanisms of coatings of single platinum group metal in high-temperature oxygen-containing environments were analyzed.On this basis,the necessity,main methods,and main achievements of alloying modification of platinum group metals were summarized.Finally,the future development of platinum group coatings with high-temperature oxidation resistance was discussed and prospected.
基金supported by the Natural Science Foundation of Chongqing,No.CSTB2023NSCQ-mSX0561(to WL).
文摘Effective treatment methods for stroke,a common cerebrovascular disease with a high mortality rate,are still being sought.Exosome therapy,a form of acellular therapy,has demonstrated promising efficacy in various diseases in animal models;however,there is currently insufficient evidence to guide the clinical application of exosome in patients with stroke.This article reviews the progress of exosome applications in stroke treatment.It aims to elucidate the significant potential value of exosomes in stroke therapy and provide a reference for their clinical translation.At present,many studies on exosome-based therapies for stroke are actively underway.Regarding preclinical research,exosomes,as bioactive substances with diverse sources,currently favor stem cells as their origin.Due to their high plasticity,exosomes can be effectively modified through various physical,chemical,and genetic engineering methods to enhance their efficacy.In animal models of stroke,exosome therapy can reduce neuroinflammatory responses,alleviate oxidative stress damage,and inhibit programmed cell death.Additionally,exosomes can promote angiogenesis,repair and regenerate damaged white matter fiber bundles,and facilitate the migration and differentiation of neural stem cells,aiding the repair process.We also summarize new directions for the application of exosomes,specifically the exosome intervention through the ventricular-meningeal lymphatic system.The review findings suggest that the treatment paradigm for stroke is poised for transformation.
基金Supported by Army Logistics Department Health Bureau Project,No.QJGYXYJZX-012.
文摘BACKGROUND Due to the dry and cold climate,the obvious temperature difference between day and night,and the low oxygen content of the air in the plateau area,people are prone to upper respiratory tract diseases,and often the condition is prolonged,and the patients are prone to anxiety and uneasiness,which may be related to the harshness of the plateau environment,somatic discomfort due to the lack of oxygen,anxiety about the disease,and other factors.AIM To investigate the effects of cognitive behavioral therapy(CBT)on anxiety,sleep disorders,and hypoxia tolerance in patients with high-altitude respiratory diseases.METHODS A total of 2337 patients with high-altitude-related respiratory diseases treated at our hospital between November 2023 and January 2024 were selected as the study subjects.The subjects’pre-high-altitude residential altitude was approximately 1700 meters.They were divided into two groups.Both groups were given symptomatic treatment,and the control group implemented conventional nursing intervention,while the research group simultaneously conducted CBT intervention;assessed the degree of health knowledge of the two groups,and applied the Hamilton Anxiety Scale and the Pittsburgh Sleep Quality Index to assess the anxiety and sleep quality of the patients before and after the intervention,respectively.It also observed the length and efficiency of sleep,and detected the level of serum hypoxia inducible factor-1α,erythropoietin(EPO)and clinical intervention before and after intervention.EPO levels,and investigated satisfaction with the clinical intervention.RESULTS The rate of excellent health knowledge in the intervention group was 93.64%,which was higher than that in the control group(74.23%;P<0.05).Before the intervention,there was no significant difference in Hamilton Anxiety Scale and Pittsburgh Sleep Quality Index scores between the two groups(P>0.05),and after the intervention,the scores of the study group were significantly lower than those of the control group(P<0.05).There was no significant difference in sleep duration and sleep efficiency between the groups before the intervention(P>0.05),and after the intervention,the scores of the study group were significantly larger than those of the control group(P<0.05).There was no significant difference in serum hypoxia inducible factor-1αand EPO between the two groups before intervention(P>0.05),and both research groups were significantly lower than the control group after intervention(P<0.05).According to the questionnaire survey,the intervention satisfaction of the study group was 95.53%,which was higher than that of the control group(80.14%;P<0.05).CONCLUSION The CBT intervention in the treatment of patients with high-altitude-related respiratory diseases helps improve patients'health knowledge,relieve anxiety,improve sleep quality and hypoxia tolerance,and improve nursing satisfaction.
基金supported by the National Natural Science Foundation of China,Nos.82271132(to YL),82101167(to BB)the Natural Science Foundation of Chongqing,Nos.CSTB2022NSCQ-MSX0020(to BB),cstc2019jcyj-msxmX0473(to FC).
文摘Our previous study demonstrated that combined transplantation of bone marrow mesenchymal stem cells and retinal progenitor cells in rats has therapeutic effects on retinal degeneration that are superior to transplantation of retinal progenitor cells alone.Bone marrow mesenchymal stem cells regulate and interact with various cells in the retinal microenvironment by secreting neurotrophic factors and extracellular vesicles.Small extracellular vesicles derived from bone marrow mesenchymal stem cells,which offer low immunogenicity,minimal tumorigenic risk,and ease of transportation,have been utilized in the treatment of various neurological diseases.These vesicles exhibit various activities,including anti-inflammatory actions,promotion of tissue repair,and immune regulation.Therefore,novel strategies using human retinal progenitor cells combined with bone marrow mesenchymal stem cell-derived small extracellular vesicles may represent an innovation in stem cell therapy for retinal degeneration.In this study,we developed such an approach utilizing retinal progenitor cells combined with bone marrow mesenchymal stem cell-derived small extracellular vesicles to treat retinal degeneration in Royal College of Surgeons rats,a genetic model of retinal degeneration.Our findings revealed that the combination of bone marrow mesenchymal stem cell-derived small extracellular vesicles and retinal progenitor cells significantly improved visual function in these rats.The addition of bone marrow mesenchymal stem cell-derived small extracellular vesicles as adjuvants to stem cell transplantation with retinal progenitor cells enhanced the survival,migration,and differentiation of the exogenous retinal progenitor cells.Concurrently,these small extracellular vesicles inhibited the activation of regional microglia,promoted the migration of transplanted retinal progenitor cells to the inner nuclear layer of the retina,and facilitated their differentiation into photoreceptors and bipolar cells.These findings suggest that bone marrow mesenchymal stem cell-derived small extracellular vesicles potentiate the therapeutic efficacy of retinal progenitor cells in retinal degeneration by promoting their survival and differentiation.
基金supported by the National Natural Science Foundation of China(32270887,82272507,32200654,82430079,and 82472519)the National Key Research and Development Program of China(2022YFA1103202)+7 种基金the Chongqing High-End Medical Talents for Middle-aged and Young(YXGD202408)the Army Scientific and Technological Innovation Talents Prioritized Suppor t Program(2023-124)the Natural Science Foundation of Chongqing(CSTB2023NSCQ-ZDJO008)the Postdoctoral Innovative Talent Support Program(BX20220397)the Open Project of State Key Laboratory of TraumaBurns and Combined Injury(SFLKF202201)the Project for Enhancing Innovation of Army Medical University(2023XJS39)the Talent Innovation Training Program at the Army Medical Center(ZXZYTSYS09)。
文摘Background:Lumbar disc degeneration(LDD)displays considerable heterogeneity in terms of clinical features and pathological changes.However,researchers have not clearly determined whether the transcriptome variations in LDD could be used to identify or interpret the causes of heterogeneity in clinical features.This study aimed to identify the transcriptomic classification of degenerated discs in LDD patients and whether the molecular subtypes of LDD could be accurately predicted using clinical features.Methods:One hundred and twenty-two nucleus pulposus(NP)tissues from 108 patients were consecutively collected for bulk RNA sequencing(RNA-seq).An unsupervised clustering method was employed to analyze the bulk RNA matrix.Differential analysis was performed to characterize the transcriptional signatures and subtype-specific extracellular matrix(ECM)dysregulation.The cell subpopulation states of each subtype were inferred by integrating bulk and single-cell sequencing datasets.Transwell and dual-luciferase reporter gene assays were employed to investigate possible molecular mechanisms involved.Machine learning algorithm diagnostic prediction models were developed to correlate molecular classification with clinical features.Results:LDD was classified into 4 subtypes with distinct molecular signatures and ECM remodeling:C1 with collagenesis,C2 with ossification,C3 with low chondrogenesis,and C4 with fibrogenesis.Chond1-3 in C1 dominated disc collagenesis via the activation of the mechanosensors TRPV4 and PIEZO1;NP progenitor cells in C2 exhibited chondrogenic and osteogenic phenotypes;Chond1 in C3 was linked to a disrupted hypoxic microenvironment leading to reduced chondrogenesis;Macrophages in C4 played a crucial role in disc fibrogenesis via the secretion of tumor necrosis factor-α(TNF-α).Furthermore,the random forest diagnostic prediction model was proven to have a robust performance[area under the receiver operating characteristic(ROC)curve:0.9312;accuracy:0.84]in stratifying the molecular subtypes of LDD based on 12 clinical features.Conclusions:Our study delineates 4 distinct molecular subtypes of LDD that can be accurately stratified on the basis of clinical features.The identification of these subtypes would facilitate precise diagnostics and guide the development of personalized treatment strategies for LDD.
文摘BACKGROUND Perimenopausal women are prone to anxiety and depression due to fluctuating hormone levels,which significantly impair their quality of life.The current treatments have certain limitations.In traditional Chinese medicine,liver-soothing formulas are commonly prescribed for mood-related disorders,but their overall efficacy in perimenopausal anxiety and depression remains uncertain and requires verification through meta-analysis.AIM To provide evidence-based support for clinical decision-making and research,a meta-analysis was conducted to evaluate the effectiveness of liver-soothing formulas in treating perimenopausal anxiety and depression.METHODS Relevant studies published up to April 2025 were retrieved from ClinicalTrials.gov,PubMed,Web of Science,EMBASE,and the Cochrane Library.Eligible studies were screened according to predefined inclusion and exclusion criteria.Data were extracted and analyzed using the Stata 12.0 software.RESULTS After searching and screening,12 articles involving 1798 patients(922 in the treatment group and 876 in the control group)were included in the analysis.Meta-analysis showed that the standardized scores for anxiety[standardized mean difference(SMD)=-0.71,95%confidence interval(95%CI):-1.06 to-0.36]and depression(SMD=-0.67,95%CI:-1.06 to-0.27)of the treatment group were lower than those of the control group.Subgroup analysis results revealed that for anxiety,liver-soothing formulas used alone(SMD=-0.34,95%CI:-0.50 to-0.18)or in combination(SMD=-0.88,95%CI:-1.43 to-0.34)both significantly reduced scores compared with the control group.For depression,monotherapy of liversoothing formulas showed no significant statistical difference between the treatment and control groups(SMD=-0.47,95%CI:-1.11 to 0.17),whereas combination therapy produced significantly lower standardized scale scores in the treatment group than in the control group,with a statistically significant difference(SMD=-0.83,95%CI:-1.39 to-0.28).Regarding Greene scores,no statistically significant difference was observed with monotherapy(SMD=0.87,95%CI:-0.32 to 2.06),whereas combination therapy had significantly lower Greene scores(SMD=-0.24,95%CI:-0.44 to-0.04).No statistically significant difference was found between the groups in the occurrence of adverse reactions(odds ratio=0.90,95%CI:0.57-1.43).However,liver-soothing formulas did not affect estrogen levels in perimenopausal women.CONCLUSION Compared with placebo,conventional Western medicine,or other interventions,the monotherapy of liver-soothing formulas demonstrates superior efficacy in treating perimenopausal anxiety.When used as an adjuvant,they exert a synergistic effect in alleviating negative emotions and improving overall perimenopausal symptoms.
基金Supported by Chongqing Health Commission and Chongqing Science and Technology Bureau,No.2023MSXM182。
文摘Rheumatoid arthritis(RA)patients face significant psychological challenges alongside physical symptoms,necessitating a comprehensive understanding of how psychological vulnerability and adaptation patterns evolve throughout the disease course.This review examined 95 studies(2000-2025)from PubMed,Web of Science,and CNKI databases including longitudinal cohorts,randomized controlled trials,and mixed-methods research,to characterize the complex interplay between biological,psychological,and social factors affecting RA patients’mental health.Findings revealed three distinct vulnerability trajectories(45%persistently low,30%fluctuating improvement,25%persistently high)and four adaptation stages,with critical intervention periods occurring 3-6 months postdiagnosis and during disease flares.Multiple factors significantly influence psychological outcomes,including gender(females showing 1.8-fold increased risk),age(younger patients experiencing 42%higher vulnerability),pain intensity,inflammatory markers,and neuroendocrine dysregulation(48%showing cortisol rhythm disruption).Early psychological intervention(within 3 months of diagnosis)demonstrated robust benefits,reducing depression incidence by 42%with effects persisting 24-36 months,while different modalities showed complementary advantages:Cognitive behavioral therapy for depression(Cohen’s d=0.68),mindfulness for pain acceptance(38%improvement),and peer support for meaning reconstruction(25.6%increase).These findings underscore the importance of integrating routine psychological assessment into standard RA care,developing stage-appropriate interventions,and advancing research toward personalized biopsychosocial approaches that address the dynamic psychological dimensions of the disease.
基金funded by scientific research projects under Grant JY2024B011.
文摘Accurate prediction of remaining useful life serves as a reliable basis for maintenance strategies,effectively reducing both the frequency of failures and associated costs.As a core component of PHM,RUL prediction plays a crucial role in preventing equipment failures and optimizing maintenance decision-making.However,deep learning models often falter when processing raw,noisy temporal signals,fail to quantify prediction uncertainty,and face challenges in effectively capturing the nonlinear dynamics of equipment degradation.To address these issues,this study proposes a novel deep learning framework.First,a newbidirectional long short-termmemory network integrated with an attention mechanism is designed to enhance temporal feature extraction with improved noise robustness.Second,a probabilistic prediction framework based on kernel density estimation is constructed,incorporating residual connections and stochastic regularization to achieve precise RUL estimation.Finally,extensive experiments on the C-MAPSS dataset demonstrate that our method achieves competitive performance in terms of RMSE and Score metrics compared to state-of-the-artmodels.More importantly,the probabilistic output provides a quantifiablemeasure of prediction confidence,which is crucial for risk-informed maintenance planning,enabling managers to optimize maintenance strategies based on a quantifiable understanding of failure risk.
