Objective:To explore the effect of implementing the case-based three-dimensional teaching method guided by evidence-based thinking in the teaching of trainee nurses in the rehabilitation department.Method:Eighty nursi...Objective:To explore the effect of implementing the case-based three-dimensional teaching method guided by evidence-based thinking in the teaching of trainee nurses in the rehabilitation department.Method:Eighty nursing practice nurses who were conducting clinical practice learning in the Rehabilitation Department of Deyang People’s Hospital from June 2024 to May 2025 were selected as the research subjects.By using the controlled grouping method,the practice nurses from June 2024 to November 2024 were taken as the control group(n=40).The period from December 2024 to May 2025 was taken as the experimental group(n=40 students),the control group was taught by traditional teaching methods,and the experimental group was taught by evidence-based nursing combined with case teaching method.The clinical thinking ability,autonomous learning ability,exit assessment scores and teaching satisfaction of the two groups of intern nurses at the time of leaving the department were compared.Results:At the time of leaving the department,the scores of each dimension and the total score of clinical thinking ability of the intern nurses in the experimental group were higher than those in the control group(t=9.268,6.354,6.199)9.694,all p<0.05).At the time of leaving the department the scores of each dimension and the total score of the autonomous learning ability of the intern nurses in the experimental group were higher than those in the control group(t=6.998,7.333,5.503,5.977,22.244)all p<0.05).At the time of leaving the department the theoretical assessment scores and operational assessment scores of the experimental group were both higher than those of the control group(t=14.546,11.676,all p<0.05).At the time of graduation,the teaching satisfaction of the experimental group was higher than that of the control group(χ^(2)=7.314,p<0.05.Conclusion:The adoption of the case-based three-dimensional teaching.Rehabilitation method guided by the evidence-based ideology during the teaching process can effectively improve the clinical thinking ability,autonomous learning ability,departmental assessment results and teaching satisfaction of the intern nurses in the rehabilitation department,which is worthy of reference.展开更多
As a critical department ensuring the sterility of hospital instruments,the Sterile Supply Center(SSC)directly impacts the sterility status of clinical instruments through its sterilization qualification rate.Geriatri...As a critical department ensuring the sterility of hospital instruments,the Sterile Supply Center(SSC)directly impacts the sterility status of clinical instruments through its sterilization qualification rate.Geriatric patients,due to physiological decline and compromised immune function,constitute a high-risk group for hospital-acquired infections,with more stringent requirements for instrument sterility.This paper analyzes the current status and influencing factors of sterilization qualification rates in SSCs,explores the mechanistic association between sterilization qualification rates and infections in geriatric departments,and proposes targeted strategies to improve sterilization qualification rates.It highlights the pivotal role of SSC instrument sterilization in infection prevention and control for geriatric patients,providing theoretical basis and practical guidance for optimizing SSC management,reducing infection rates in geriatric departments,and ensuring the safety of elderly patients’medical care.These findings aim to enhance overall infection management standards in hospitals.展开更多
Urinary tract infections(UTIs)are among the most prevalent pediatric bacterial infections,and undertreated episodes may lead to renal scarring,hypertension,or chronic kidney disease.Multidrug-resistant(MDR)Enterobacte...Urinary tract infections(UTIs)are among the most prevalent pediatric bacterial infections,and undertreated episodes may lead to renal scarring,hypertension,or chronic kidney disease.Multidrug-resistant(MDR)Enterobacterales have been increasingly reported in children,with higher rates in Asian and Middle Eastern settings than in high-income countries[1,2].展开更多
BACKGROUND With the increasing use of laparoscopic techniques in living-donor kidney transplantation,limitations in donor vessel length,particularly of the right renal vein,pose significant challenges for vascular ana...BACKGROUND With the increasing use of laparoscopic techniques in living-donor kidney transplantation,limitations in donor vessel length,particularly of the right renal vein,pose significant challenges for vascular anastomosis to the recipient’s external iliac vein.These anatomical constraints can complicate graft implantation and increase the risk of postoperative complications.CASE SUMMARY To address the issue of short right renal veins,several surgical strategies have been proposed.In this report,we describe our experience with three cases in which venous extension was successfully achieved using a venous cuff interposition technique during back-table reconstruction.This approach was used to facilitate secure vascular anastomosis and improve graft positioning in anatomically complex transplant scenarios.CONCLUSION Venous cuff interposition represents an effective technique for managing short renal veins in living-donor kidney transplantation.It provides additional length and flexibility,easing anastomotic tension and supporting successful transplantation.展开更多
Objective:To compare the effectiveness,safety,acceptability,and confounding factors of the two-rod levonorgestrel implants between the Indoplant and Sinoplant implant brands.Methods:The study was a double-blind,random...Objective:To compare the effectiveness,safety,acceptability,and confounding factors of the two-rod levonorgestrel implants between the Indoplant and Sinoplant implant brands.Methods:The study was a double-blind,randomized controlled trial at three different centers in Indonesia.A total of 531 participants that met inclusion and exclusion criteria were randomized into two groups,with 264 participants in the Sinoplant group and 267 participants in the Indoplant group.At each center,participants were divided into two groups for Sinoplant and Indoplant.The participants were followed up for 36 months.Four parameters were evaluated:implant effectiveness,safety,acceptability,and confounding factors.Results:A total of 531 eligible participants were enrolled in this study.Both Sinoplant and Indoplant showed 100%efficacy in preventing pregnancy,with no significant differences in side effects.24.22%of the Sinoplant group and 22.18%of the Indoplant group reported weight changes.8.60%of the Sinoplant group and 9.73%of the Indoplant group reported menstrual changes,and 1.17%of the both groups experienced intermenstrual bleeding.Implant acceptability was 96.61%,with 3.39%dropout rates.Confounding factors such as age,parity,and contraceptive history did not significantly differ between the two groups.Conclusions:Sinoplant and Indoplant did not differ significantly in contraceptive effectiveness,safety,acceptability,and confounding factors.展开更多
BACKGROUND:Maxillofacial trauma represents a significant challenge in emergency medicine,requiring both diagnostic accuracy and prompt intervention while balancing immediate life-saving interventions with preservation...BACKGROUND:Maxillofacial trauma represents a significant challenge in emergency medicine,requiring both diagnostic accuracy and prompt intervention while balancing immediate life-saving interventions with preservation of function and aesthetics.The complex anatomy of this region,with its proximity to critical structures,demands a thorough understanding of assessment and management principles.This narrative review aims to provide evidence-based guidelines for emergency physicians managing maxillofacial trauma,with particular emphasis on early recognition of critical injuries,airway management strategies,and special population considerations.METHODS:A narrative review was conducted via a comprehensive literature search of the PubMed and Scopus databases,which focused on maxillofacial trauma management in emergency settings.Articles were selected based on relevance to clinical practice,methodological quality,and current management guidelines.The review synthesized evidence from multiple study types,including original research,systematic reviews,and clinical practice guidelines,to provide practical guidance for emergency physicians.RESULTS:Initial assessment following Advanced Trauma Life Support(ATLS)principles is crucial,with airway management being a primary concern due to the risk of dynamic obstruction.Critical time-sensitive emergencies include orbital compartment syndrome,trapdoor fractures(in pediatric patients),and facial nerve injuries.Computed tomography(CT)imaging remains the gold standard for diagnosis.Special considerations are required for pediatric patients,who present unique anatomical challenges and injury patterns,and for elderly patients,who often have complex medical comorbidities and increased complication risks.Management strategies range from conservative treatment to urgent surgical intervention,with decisions based on the injury pattern and associated complications.CONCLUSION:Emergency physicians must maintain a structured yet fl exible approach to maxillofacial trauma,focusing on early recognition of critical injuries,appropriate airway management,and timely specialist consultation.Understanding injury patterns and their potential complications allows for eff ective risk stratifi cation and treatment planning,ultimately improving patient outcomes.展开更多
BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suita...BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suitable for rapid clinical application.METHODS:In this multi-center retrospective cohort study,AAS patient data from three hospitals were analyzed.The modeling cohort included data from the First Affiliated Hospital of Zhengzhou University and the People’s Hospital of Xinjiang Uygur Autonomous Region,with Peking University Third Hospital data serving as the external test set.Four machine learning algorithms—logistic regression(LR),multilayer perceptron(MLP),Gaussian naive Bayes(GNB),and random forest(RF)—were used to develop predictive models based on 34 early-accessible clinical variables.A simplifi ed model was then derived based on fi ve key variables(Stanford type,pericardial eff usion,asymmetric peripheral arterial pulsation,decreased bowel sounds,and dyspnea)via Least Absolute Shrinkage and Selection Operator(LASSO)regression to improve ED applicability.RESULTS:A total of 929 patients were included in the modeling cohort,and 210 were included in the external test set.Four machine learning models based on 34 clinical variables were developed,achieving internal and external validation AUCs of 0.85-0.90 and 0.73-0.85,respectively.The simplifi ed model incorporating fi ve key variables demonstrated internal and external validation AUCs of 0.71-0.86 and 0.75-0.78,respectively.Both models showed robust calibration and predictive stability across datasets.CONCLUSION:Both kinds of models were built based on machine learning tools,and proved to have certain prediction performance and extrapolation.展开更多
A hybrid model combining Fully Non-Linear Potential Flow Theory(FNPT)based on the Finite Element Method(FEM)and the Unified Navier-Stokes equation,using the 3D Improved Meshless Local Petrov Galerkin method with Ranki...A hybrid model combining Fully Non-Linear Potential Flow Theory(FNPT)based on the Finite Element Method(FEM)and the Unified Navier-Stokes equation,using the 3D Improved Meshless Local Petrov Galerkin method with Rankine Source(IMLPG_R),is developed to study wave interactions with a porous layer.In previous studies,the above formulations are applied to wave interaction with fixed cylindrical structures.The present study extends this framework by integrating a unified governing equation within the hybrid modeling approach to capture the dynamics of wave interaction with porous media.The porous layers are employed to replicate the wave-dissipating behavior of the structure.A weak coupling strategy is implemented within a designated buffer zone,wherein field variables from the 2D Fully Nonlinear Potential Theory(FNPT)simulations are transferred to the 3D Improved Moving Least Squares-based Petrov-Galerkin(IMLPG_R)model at each time step.This domain decomposition significantly reduces computational cost compared to a full 3D simulation by partitioning the domain into two subregions:the FNPT domain representing the far-field without structures,and the IMLPG_R domain encompassing the porous region.The Unified Navier-Stokes formulation is extended by incorporating additional drag forces governed by Darcy’s law to model the resistance introduced by the porous medium.A stationary background node framework is utilized for interpolation by fluid particles at each time step to accommodate the porous representation.To enhance numerical stability and accuracy,particularly in the presence of sloping boundaries,the Particle Shifting Technique(PST)is integrated into the IMLPG_R model.This implementation involves a modified version of the PST algorithm,where key parameters such as the weight function,velocity ratio,and radius of influence are optimized for IMLPG_R.This is the first time the application of 3D IMLPG_R for porous structure has been reported.Further,the model is subsequently validated against experimental data.展开更多
BACKGROUND Appropriate care for individuals who attempt suicide and are admitted to the emergency department(ED)can prevent future suicidal behavior.It is vital to understand their sociodemographic characteristics and...BACKGROUND Appropriate care for individuals who attempt suicide and are admitted to the emergency department(ED)can prevent future suicidal behavior.It is vital to understand their sociodemographic characteristics and the effects of targeted psychological care.AIM To analyze sociodemographic characteristics of suicide attempters treated in the ED and evaluate the efficacy of psychological care.METHODS Data from 239 suicide attempters treated in the ED of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture(Hubei Province,China)between January 2021 and February 2025 were divided into 2:Control(n=108)and psychological care(n=131).The demographic characteristics and effects of the psychological care were analyzed.RESULTS The mean(±SD)age of the 239 patients[114 male(47.7%),125 female(52.3%)]was 26.25±9.3 years,of whom 122(45.2%)were single,117(48.9%)were married,and 106(44.4%)had secondary education.Thirty-eight(15.9%)patients had suicidal intent,with a mean of 1.26±0.59 suicide attempts each.Twenty-two(9.21%)patients had a family history of suicide,while 8(3.34%)had a family history of suicide attempt(s).Before intervention,mean Suicidal Intent Scale scores in the psychological nursing and control groups were 21.57±5.28 and 19.86±5.92,respectively(P>0.05).After 1 month of nursing intervention,the respective scores were 10.09±1.11 and 16.48±0.87(P<0.001);and the re-suicide rates were 11.45%(15/131)and 24.07%(26/108)(P<0.001).CONCLUSION Psychological care significantly reduces suicide risk;EDs should provide comprehensive mental health care.展开更多
Moirésuperlattices hosting flat bands and correlated states have become a central focus in condensed matter research.Using first-principles calculations,we investigate three-dimensional flat bands in alternating ...Moirésuperlattices hosting flat bands and correlated states have become a central focus in condensed matter research.Using first-principles calculations,we investigate three-dimensional flat bands in alternating twisted NbSe_(2)moirébulk structures,which exhibit stronger interlayer interactions than twisted bilayer configurations.Our results show that moirébulks undergo spontaneous large-scale structural relaxation,leading to the formation of remarkably flat energy bands at twist angles≤7.31°.The k_(z)-dependent dispersion of these flat bands across different moirébulks highlights their intrinsic three-dimensional character.Moreover,the presence of out-of-plane mirror symmetry in these moirébulk structures indicates potential interlayer triplet superconducting pairing mechanisms,distinct from those in twisted bilayer systems.This work opens new avenues for exploring three-dimensional flat bands in other moirébulk systems.展开更多
BACKGROUND Sorafenib has been the conventional treatment for advanced hepatocellular carcinoma(HCC)since 2008.While radiological complete responses are extremely rare,improved supportive care and multidisciplinary app...BACKGROUND Sorafenib has been the conventional treatment for advanced hepatocellular carcinoma(HCC)since 2008.While radiological complete responses are extremely rare,improved supportive care and multidisciplinary approaches in clinical practice may explain the recent increase in case reports and retrospective series documenting such responses.CASE SUMMARY This case series describes 3 patients with advanced HCC who achieved durable complete responses using first-line sorafenib therapy,even in the presence of portal vein thrombosis or extrahepatic spread,and highlights the potential for sustained remission in selected patients.Dermatologic toxicity and non-viral etiology may correlate with favorable outcomes;however,reliable predictive biomarkers for sorafenib response are lacking.CONCLUSION Future research into the etiology and molecular differences in HCC is necessary to develop more personalized therapy options.展开更多
This comprehensive study investigates the formation and evolution of intermetallic compounds during the solidification process of magnesium alloys using advanced micro X-ray computed tomography.By analyzing both commo...This comprehensive study investigates the formation and evolution of intermetallic compounds during the solidification process of magnesium alloys using advanced micro X-ray computed tomography.By analyzing both common industrial Mg-Al-Zn alloys and a novel rare earth-containing Mg-Ni-Gd-Y alloy,we aim to characterize the nucleation,growth,and distribution of Al-Mn and eutectic intermetallics across various stages of solidification.The non destructive imaging technique employed in this research provides high-resolution,three-dimensional insights into the microstructural development,allowing for a detailed examination of the morphology,spatial arrangement,and interconnectivity of intermetallic phases.This approach overcomes limitations of traditional two-dimensional metallographic methods,offering a more comprehensive understanding of the complex three-dimensional structures formed during solidification.展开更多
Background:Successful liver resection in oncologic surgery depends on safety,precision,and efficacy,all of which require a thorough understanding of liver anatomy.Contrast-enhanced computed tomography(CT)-generated th...Background:Successful liver resection in oncologic surgery depends on safety,precision,and efficacy,all of which require a thorough understanding of liver anatomy.Contrast-enhanced computed tomography(CT)-generated three-dimensional(3D)models have been proposed as a valuable tool to enhance this understanding.However,a systematic comparison of different display modalities across professional groups has not yet been performed.Methods:In this prospective,monocentric randomized trial,we compared high-resolution twodimensional(2D)CT images of liver malignancies with their corresponding standardized,non-colored 3D virtual and printed models in facilitating anatomical and spatial understanding as well as surgical decision-making.A total of 91 participants,including 40 surgeons,10 radiologists,and 41 students,evaluated six clinical cases(three centrally and three peripherally located liver malignancies).Each participant assessed one central and one peripheral case per display modality,presented in a random order.Results:Compared to 2D CT images,both 3D virtual and printed models significantly improved the identification of tumor location(P<0.001),enhanced the comprehension of spatial relationships with adjacent liver and portal veins(P<0.001 and P=0.019,respectively),and facilitated clinical decisionmaking(P<0.001).No significant difference was observed between virtual and printed models in terms of effectiveness.Within the different groups,surgeons and students,but not radiologists,more accurately identified tumor location and spatial relationships with adjacent liver and portal veins using 3D models.Subjectively,most surgeons and students preferred 3D printed models over virtual models and 2D CT images.Conclusions:This study demonstrated that standardized,non-colored 3D virtual and printed models equally help preoperative anatomical understanding and decision-making,particularly for surgeons and students.By isolating the influence of display modality,our findings clarify prior inconsistent results and support the integration of cost-effective 3D visualization by applying virtual models into surgical planning and education.Preference for printed models despite comparable efficacy highlights the importance of user-centered implementation strategies.展开更多
The original online version of this article was revised:The layout update for Article 758 has impacted the page range in the published issue,but did not affect the scholarly content.To ensure consistency with the orig...The original online version of this article was revised:The layout update for Article 758 has impacted the page range in the published issue,but did not affect the scholarly content.To ensure consistency with the originally assigned pages(2595-2614),we will need to publish an erratum to correct the article and restore the original page range.The original article has been corrected.展开更多
Neurodegenerative disorders represent an increasingly pertinent public health crisis.As a greater proportion of the population ages,neurodegenerative disorders and other diseases of aging place undue burdens on patien...Neurodegenerative disorders represent an increasingly pertinent public health crisis.As a greater proportion of the population ages,neurodegenerative disorders and other diseases of aging place undue burdens on patients,caregivers,and healthcare workers.Alzheimer’s disease(AD)and Parkinson’s disease represent the two most common neurodegenerative disorders in the population,affecting over 65 million people,worldwide.展开更多
Climate warming is significantly altering the distribution of tree species,which holds crucial implications for China’s Larix species as they are important afforestation efforts.Understanding their optimal habitats a...Climate warming is significantly altering the distribution of tree species,which holds crucial implications for China’s Larix species as they are important afforestation efforts.Understanding their optimal habitats and environmental constraints is vital for predicting range shifts and guiding adaptive forest management.Previous studies prioritized changing climate impacts on horizontal range shifts of Larix,neglecting the influence of soil factors and range shift along altitudinal gradients.To address this,we applied an optimized MaxEnt model to assess current and future SSP126/SSP585 scenarios,three-dimensional habitat suitability(latitude,longitude,altitude)for four major Larix species(L.principis-rupprechtii,L.gmelinii,L.kaempferi,L.olgensis),while identifying key environmental drivers.Our results indicate that elevation and extreme moisture conditions universally constrain their distribution.Soil chemistry properties exhibited species-specific influences:cation exchange capacity critically shaped L.principis-rupprechtii and L.gmelinii ranges,whereas exchangeable aluminum determined L.kaempferi and L.olgensis distribution.Under future climate scenarios,habitat areas show divergent trajectories-L.principis-rupprechtii maximum gains 5.1%under SSP126,while L.kaempferi maximum expands 15.1%.Conversely,SSP585 triggered a 3.7% decline for L.gmelinii during the 2040s−2100s,and L.olgensis faces a net reduction to 0.4% by 2100s despite transient gains.Spatially,three species(L.kaempferi,L.gmelinii,L.olgensis)shifted northward,while L.principis-rupprechtii migrated northwest.All species distribution ascended altitudinally reflecting thermal adaptation strategies.These multidimensional insights enable targeted species selection for climate-resilient afforestation and underscore the need for soil-inclusive management planning.展开更多
Stony debris flows,characterized by coarse boulders embedded in a sediment-laden matrix,greatly amplify destructive potential by altering flow dynamics and impact forces.Conventional single-phase particle-fluidmixture...Stony debris flows,characterized by coarse boulders embedded in a sediment-laden matrix,greatly amplify destructive potential by altering flow dynamics and impact forces.Conventional single-phase particle-fluidmixture models often struggle to capture the complexities introduced by coarse boulders and multi-phase interactions,while strong-coupling methods can be computationally prohibitive for practical hazard assessments.In this study,we propose a semi-hybrid,fully resolved coupling numerical framework for modeling boulder-laden debris flows.This framework conceptualizes debris flows as a composite system comprising a continuous viscous fluidphase(including finesediments)and a discrete phase of arbitrarily shaped coarse particles.The continuous phase is treated as a generalized nonlinear Coulomb-viscoplastic fluidusing the smoothed particle hydrodynamics(SPH)method,while coarse particles are modeled via the distributed contact discrete element method(DCDEM).These two phases are coupled through an efficienttwo-way resolved scheme,ensuring accurate simulation of flow-boulder interactions within a unifiedtimeframe.We validate the proposed method against two physical experiments:(1)gravity-driven concrete flows and(2)debris flowinteracting with slit-type barriers.Results confirmthe method's robustness in accurately capturing fluid-solid-structureinteractions and deposition processes.Its capabilities are further showcased through the simulation of a stony debris-flowevent inWenchuan County,China,highlighting its promise for real-world engineering applications and validating the effectiveness of the existing cascade dam system in mitigating debrisflowimpact and energy dissipation.展开更多
Integrated environmental management is important for sustainable development.Under China’s“Three Lines One Permit”(TLOP)policy,three types of management zones—priority protection,critical control,and general contr...Integrated environmental management is important for sustainable development.Under China’s“Three Lines One Permit”(TLOP)policy,three types of management zones—priority protection,critical control,and general control zones—are established based on the ecological red line,the lower-limit line for environmental quality,and the resource use line.Human activities are regulated through a permit system.Integrated and multifactorial protection of soil,plant,hydrological,and atmospheric elements is promoted at the regional level.A follow-up assessment contributes to the improvement of policy implementation and effectiveness.This study demonstrates the achievements of the TLOP policy in Sichuan Province.Results show that(1)276 protection zones have been established under the ecological red line,covering key ecosystems and protected areas to ensure environmental security.Under the lower-limit line,1,626 functional(priority,key,and general control)zones have been designated to regulate air,water,and soil quality,enhancing environmental capacity and pollution control.(2)Through the integration and merging of the three lines,1,128 integrated management zones have been established,including 375,625,and 128 priority protection,critical control,and general control zones,respectively.Each zone has its own list of environmental permits to regulate human activities according to different environmental protection and natural resource development regimes.(3)The design of the follow-up assessment index system was informed by regional primary functions and industrial structure.The index system for provinces and cities is structured around three primary indicators—implementation updating,application,and guarantees—and 15 secondary indicators.The system for critical control zones is structured around environmental access,management,and effectiveness and 14 secondary indicators.A stringent environmental zoning system has been established through the TLOP policy,thereby safeguarding environmental security,promoting harmonious existence between humans and nature,and supporting the vision of Beautiful China.展开更多
Objectives:24-h movement behaviors(24-HMB),encompassing physical activity,sedentary behavior,and sleep duration,are increasingly regarded as interrelated and important factors for mental health.However,evidence on the...Objectives:24-h movement behaviors(24-HMB),encompassing physical activity,sedentary behavior,and sleep duration,are increasingly regarded as interrelated and important factors for mental health.However,evidence on the comprehensive association of these behaviors with mental health in adults with diabetes in developing countries remains scarce.This study examined the association between 24-HMB guidelines and psychological health among adults with diabetes in developing countries.Methods:Data were retrieved from the World Health Organization’s study on Global Aging and Adult Health Survey dataset.Adults(N=1905)diagnosed with diabetes from five low-and middle-income countries were included.The exposure of interest was adherence to 24-HMB guidelines,depression,cognition,and quality of life(QoL).Multiple logistic and multiple linear regression analyses were used to examine the association between meeting 24-HMB guidelines and depression,cognition,and QoL,respectively.Results:This cross-sectional study revealed that 28.61%complied with all three 24-HMB guidelines.Diabetic patients who met more numbers of 24-HMB guidelines had lower depression risk(OR=0.74,95%CI:0.61 to 0.91,p=0.004),greater cognition(β=0.42,95%CI:0.25 to 0.60,p<0.001),and QoL(β=1.30,95%CI:1.04 to 1.55,p<0.001)with the non-compliant population.For specific combinations,meeting all three guidelines were significantly associated with lower odds of depression,improved cognitive function,and enhanced QoL(all p<0.001).Conclusion:These findings support that meeting 24-HMB guidelines in a single or combined movement behaviors was significantly related to reduced risk of depression,enhanced cognitive function,and improved QoL among individuals with diabetes.展开更多
AIM:To evaluate the differences and consistency of vault measurements obtained by Scheimpflug tomography(Pentacam),anterior segment optical coherence tomography(AS-OCT,CASIA II),and ultrasound biomicroscopy(UBM)follow...AIM:To evaluate the differences and consistency of vault measurements obtained by Scheimpflug tomography(Pentacam),anterior segment optical coherence tomography(AS-OCT,CASIA II),and ultrasound biomicroscopy(UBM)following implantable collamer lens(ICL)V4c implantation.METHODS:Vault measurements were acquired using three modalities:Pentacam,CASIA II AS-OCT,and UBM.Repeated-measures analysis of variance was used to compare the vault values obtained by the three devices.The correlation and consistency of measurements among the three instruments were assessed using the Pearson correlation coefficient,intraclass correlation coefficient(ICC),and Bland-Altman plots.RESULTS:This retrospective study enrolled 210 myopic eyes of 210 patients(158 women and 52 men)who underwent ICL implantation:108 eyes had a myopic ICL V4c implanted,and 102 eyes had a toric ICL V4c implanted.The mean vault values measured by Pentacam,CASIA II,and UBM were 452.64±204.20μm,538.57±203.54μm,and 560.95±227.54μm,respectively,with statistically significant differences among the three groups(P<0.05).Pearson correlation analysis showed strong positive correlations between vault values measured by different instruments(all P<0.001).ICC results indicated good consistency among the three measurement modalities(all P<0.001).Stratified analysis revealed that when the vault value was≤250μm,the correlation and consistency of measurements across the three instruments were lower than those in the medium and high vault subgroups.CONCLUSION:Vault values measured by Pentacam are lower than those obtained by CASIA II and UBM,with UBM yielding the highest mean vault values.Measurements from the three instruments are not interchangeable but can serve as mutual references due to their significant correlation and good overall consistency.Pentacam and CASIA II demonstrate the highest consistency in vault measurement.Notably,when the vault value is≤250μm,the consistency between Pentacam and the other two instruments decreases significantly.展开更多
基金2023 Higher Education Teaching Research and Reform Project of Southwest Medical University(Project No.:JG2023jdyb033)。
文摘Objective:To explore the effect of implementing the case-based three-dimensional teaching method guided by evidence-based thinking in the teaching of trainee nurses in the rehabilitation department.Method:Eighty nursing practice nurses who were conducting clinical practice learning in the Rehabilitation Department of Deyang People’s Hospital from June 2024 to May 2025 were selected as the research subjects.By using the controlled grouping method,the practice nurses from June 2024 to November 2024 were taken as the control group(n=40).The period from December 2024 to May 2025 was taken as the experimental group(n=40 students),the control group was taught by traditional teaching methods,and the experimental group was taught by evidence-based nursing combined with case teaching method.The clinical thinking ability,autonomous learning ability,exit assessment scores and teaching satisfaction of the two groups of intern nurses at the time of leaving the department were compared.Results:At the time of leaving the department,the scores of each dimension and the total score of clinical thinking ability of the intern nurses in the experimental group were higher than those in the control group(t=9.268,6.354,6.199)9.694,all p<0.05).At the time of leaving the department the scores of each dimension and the total score of the autonomous learning ability of the intern nurses in the experimental group were higher than those in the control group(t=6.998,7.333,5.503,5.977,22.244)all p<0.05).At the time of leaving the department the theoretical assessment scores and operational assessment scores of the experimental group were both higher than those of the control group(t=14.546,11.676,all p<0.05).At the time of graduation,the teaching satisfaction of the experimental group was higher than that of the control group(χ^(2)=7.314,p<0.05.Conclusion:The adoption of the case-based three-dimensional teaching.Rehabilitation method guided by the evidence-based ideology during the teaching process can effectively improve the clinical thinking ability,autonomous learning ability,departmental assessment results and teaching satisfaction of the intern nurses in the rehabilitation department,which is worthy of reference.
文摘As a critical department ensuring the sterility of hospital instruments,the Sterile Supply Center(SSC)directly impacts the sterility status of clinical instruments through its sterilization qualification rate.Geriatric patients,due to physiological decline and compromised immune function,constitute a high-risk group for hospital-acquired infections,with more stringent requirements for instrument sterility.This paper analyzes the current status and influencing factors of sterilization qualification rates in SSCs,explores the mechanistic association between sterilization qualification rates and infections in geriatric departments,and proposes targeted strategies to improve sterilization qualification rates.It highlights the pivotal role of SSC instrument sterilization in infection prevention and control for geriatric patients,providing theoretical basis and practical guidance for optimizing SSC management,reducing infection rates in geriatric departments,and ensuring the safety of elderly patients’medical care.These findings aim to enhance overall infection management standards in hospitals.
文摘Urinary tract infections(UTIs)are among the most prevalent pediatric bacterial infections,and undertreated episodes may lead to renal scarring,hypertension,or chronic kidney disease.Multidrug-resistant(MDR)Enterobacterales have been increasingly reported in children,with higher rates in Asian and Middle Eastern settings than in high-income countries[1,2].
文摘BACKGROUND With the increasing use of laparoscopic techniques in living-donor kidney transplantation,limitations in donor vessel length,particularly of the right renal vein,pose significant challenges for vascular anastomosis to the recipient’s external iliac vein.These anatomical constraints can complicate graft implantation and increase the risk of postoperative complications.CASE SUMMARY To address the issue of short right renal veins,several surgical strategies have been proposed.In this report,we describe our experience with three cases in which venous extension was successfully achieved using a venous cuff interposition technique during back-table reconstruction.This approach was used to facilitate secure vascular anastomosis and improve graft positioning in anatomically complex transplant scenarios.CONCLUSION Venous cuff interposition represents an effective technique for managing short renal veins in living-donor kidney transplantation.It provides additional length and flexibility,easing anastomotic tension and supporting successful transplantation.
基金supported by PT.Catur Dakwah Crane Pharmacy,an Indonesian pharmaceutical company.The funding was granted through a mutual agreement between the research team and the company,under the coordination of the National Population and Family Planning Board(BKKBN Indonesia).The funder provided financial support only and had no role in the study design,data collection,analysis,interpretation of data,or the decision to submit the manuscript for publication.
文摘Objective:To compare the effectiveness,safety,acceptability,and confounding factors of the two-rod levonorgestrel implants between the Indoplant and Sinoplant implant brands.Methods:The study was a double-blind,randomized controlled trial at three different centers in Indonesia.A total of 531 participants that met inclusion and exclusion criteria were randomized into two groups,with 264 participants in the Sinoplant group and 267 participants in the Indoplant group.At each center,participants were divided into two groups for Sinoplant and Indoplant.The participants were followed up for 36 months.Four parameters were evaluated:implant effectiveness,safety,acceptability,and confounding factors.Results:A total of 531 eligible participants were enrolled in this study.Both Sinoplant and Indoplant showed 100%efficacy in preventing pregnancy,with no significant differences in side effects.24.22%of the Sinoplant group and 22.18%of the Indoplant group reported weight changes.8.60%of the Sinoplant group and 9.73%of the Indoplant group reported menstrual changes,and 1.17%of the both groups experienced intermenstrual bleeding.Implant acceptability was 96.61%,with 3.39%dropout rates.Confounding factors such as age,parity,and contraceptive history did not significantly differ between the two groups.Conclusions:Sinoplant and Indoplant did not differ significantly in contraceptive effectiveness,safety,acceptability,and confounding factors.
文摘BACKGROUND:Maxillofacial trauma represents a significant challenge in emergency medicine,requiring both diagnostic accuracy and prompt intervention while balancing immediate life-saving interventions with preservation of function and aesthetics.The complex anatomy of this region,with its proximity to critical structures,demands a thorough understanding of assessment and management principles.This narrative review aims to provide evidence-based guidelines for emergency physicians managing maxillofacial trauma,with particular emphasis on early recognition of critical injuries,airway management strategies,and special population considerations.METHODS:A narrative review was conducted via a comprehensive literature search of the PubMed and Scopus databases,which focused on maxillofacial trauma management in emergency settings.Articles were selected based on relevance to clinical practice,methodological quality,and current management guidelines.The review synthesized evidence from multiple study types,including original research,systematic reviews,and clinical practice guidelines,to provide practical guidance for emergency physicians.RESULTS:Initial assessment following Advanced Trauma Life Support(ATLS)principles is crucial,with airway management being a primary concern due to the risk of dynamic obstruction.Critical time-sensitive emergencies include orbital compartment syndrome,trapdoor fractures(in pediatric patients),and facial nerve injuries.Computed tomography(CT)imaging remains the gold standard for diagnosis.Special considerations are required for pediatric patients,who present unique anatomical challenges and injury patterns,and for elderly patients,who often have complex medical comorbidities and increased complication risks.Management strategies range from conservative treatment to urgent surgical intervention,with decisions based on the injury pattern and associated complications.CONCLUSION:Emergency physicians must maintain a structured yet fl exible approach to maxillofacial trauma,focusing on early recognition of critical injuries,appropriate airway management,and timely specialist consultation.Understanding injury patterns and their potential complications allows for eff ective risk stratifi cation and treatment planning,ultimately improving patient outcomes.
基金supported by the special fund of the National Clinical Key Specialty Construction Program[(2022)301-2305].
文摘BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suitable for rapid clinical application.METHODS:In this multi-center retrospective cohort study,AAS patient data from three hospitals were analyzed.The modeling cohort included data from the First Affiliated Hospital of Zhengzhou University and the People’s Hospital of Xinjiang Uygur Autonomous Region,with Peking University Third Hospital data serving as the external test set.Four machine learning algorithms—logistic regression(LR),multilayer perceptron(MLP),Gaussian naive Bayes(GNB),and random forest(RF)—were used to develop predictive models based on 34 early-accessible clinical variables.A simplifi ed model was then derived based on fi ve key variables(Stanford type,pericardial eff usion,asymmetric peripheral arterial pulsation,decreased bowel sounds,and dyspnea)via Least Absolute Shrinkage and Selection Operator(LASSO)regression to improve ED applicability.RESULTS:A total of 929 patients were included in the modeling cohort,and 210 were included in the external test set.Four machine learning models based on 34 clinical variables were developed,achieving internal and external validation AUCs of 0.85-0.90 and 0.73-0.85,respectively.The simplifi ed model incorporating fi ve key variables demonstrated internal and external validation AUCs of 0.71-0.86 and 0.75-0.78,respectively.Both models showed robust calibration and predictive stability across datasets.CONCLUSION:Both kinds of models were built based on machine learning tools,and proved to have certain prediction performance and extrapolation.
基金funded by Prime Minister’s Research Fellowship(PMRF),grant number SB22230924OEPMRF008608.
文摘A hybrid model combining Fully Non-Linear Potential Flow Theory(FNPT)based on the Finite Element Method(FEM)and the Unified Navier-Stokes equation,using the 3D Improved Meshless Local Petrov Galerkin method with Rankine Source(IMLPG_R),is developed to study wave interactions with a porous layer.In previous studies,the above formulations are applied to wave interaction with fixed cylindrical structures.The present study extends this framework by integrating a unified governing equation within the hybrid modeling approach to capture the dynamics of wave interaction with porous media.The porous layers are employed to replicate the wave-dissipating behavior of the structure.A weak coupling strategy is implemented within a designated buffer zone,wherein field variables from the 2D Fully Nonlinear Potential Theory(FNPT)simulations are transferred to the 3D Improved Moving Least Squares-based Petrov-Galerkin(IMLPG_R)model at each time step.This domain decomposition significantly reduces computational cost compared to a full 3D simulation by partitioning the domain into two subregions:the FNPT domain representing the far-field without structures,and the IMLPG_R domain encompassing the porous region.The Unified Navier-Stokes formulation is extended by incorporating additional drag forces governed by Darcy’s law to model the resistance introduced by the porous medium.A stationary background node framework is utilized for interpolation by fluid particles at each time step to accommodate the porous representation.To enhance numerical stability and accuracy,particularly in the presence of sloping boundaries,the Particle Shifting Technique(PST)is integrated into the IMLPG_R model.This implementation involves a modified version of the PST algorithm,where key parameters such as the weight function,velocity ratio,and radius of influence are optimized for IMLPG_R.This is the first time the application of 3D IMLPG_R for porous structure has been reported.Further,the model is subsequently validated against experimental data.
文摘BACKGROUND Appropriate care for individuals who attempt suicide and are admitted to the emergency department(ED)can prevent future suicidal behavior.It is vital to understand their sociodemographic characteristics and the effects of targeted psychological care.AIM To analyze sociodemographic characteristics of suicide attempters treated in the ED and evaluate the efficacy of psychological care.METHODS Data from 239 suicide attempters treated in the ED of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture(Hubei Province,China)between January 2021 and February 2025 were divided into 2:Control(n=108)and psychological care(n=131).The demographic characteristics and effects of the psychological care were analyzed.RESULTS The mean(±SD)age of the 239 patients[114 male(47.7%),125 female(52.3%)]was 26.25±9.3 years,of whom 122(45.2%)were single,117(48.9%)were married,and 106(44.4%)had secondary education.Thirty-eight(15.9%)patients had suicidal intent,with a mean of 1.26±0.59 suicide attempts each.Twenty-two(9.21%)patients had a family history of suicide,while 8(3.34%)had a family history of suicide attempt(s).Before intervention,mean Suicidal Intent Scale scores in the psychological nursing and control groups were 21.57±5.28 and 19.86±5.92,respectively(P>0.05).After 1 month of nursing intervention,the respective scores were 10.09±1.11 and 16.48±0.87(P<0.001);and the re-suicide rates were 11.45%(15/131)and 24.07%(26/108)(P<0.001).CONCLUSION Psychological care significantly reduces suicide risk;EDs should provide comprehensive mental health care.
基金supported by the National Key Research and Development Program of China(Grant No.2024YFA1410300)the National Natural Science Foundation of China(Grant No.12304217)+1 种基金the Natural Science Foundation of Hunan Province(Grant No.2025JJ60002)the Fundamental Research Funds for the Central Universities of China(Grant No.531119200247)。
文摘Moirésuperlattices hosting flat bands and correlated states have become a central focus in condensed matter research.Using first-principles calculations,we investigate three-dimensional flat bands in alternating twisted NbSe_(2)moirébulk structures,which exhibit stronger interlayer interactions than twisted bilayer configurations.Our results show that moirébulks undergo spontaneous large-scale structural relaxation,leading to the formation of remarkably flat energy bands at twist angles≤7.31°.The k_(z)-dependent dispersion of these flat bands across different moirébulks highlights their intrinsic three-dimensional character.Moreover,the presence of out-of-plane mirror symmetry in these moirébulk structures indicates potential interlayer triplet superconducting pairing mechanisms,distinct from those in twisted bilayer systems.This work opens new avenues for exploring three-dimensional flat bands in other moirébulk systems.
文摘BACKGROUND Sorafenib has been the conventional treatment for advanced hepatocellular carcinoma(HCC)since 2008.While radiological complete responses are extremely rare,improved supportive care and multidisciplinary approaches in clinical practice may explain the recent increase in case reports and retrospective series documenting such responses.CASE SUMMARY This case series describes 3 patients with advanced HCC who achieved durable complete responses using first-line sorafenib therapy,even in the presence of portal vein thrombosis or extrahepatic spread,and highlights the potential for sustained remission in selected patients.Dermatologic toxicity and non-viral etiology may correlate with favorable outcomes;however,reliable predictive biomarkers for sorafenib response are lacking.CONCLUSION Future research into the etiology and molecular differences in HCC is necessary to develop more personalized therapy options.
基金Project(2023YFB4606200)supported by the National Key Research and Development Program of ChinaProject(2023-SSRF-HZ-503114-2)supported by Shanghai Synchrotron Radiation Facility,Instrument BL16U2,China。
文摘This comprehensive study investigates the formation and evolution of intermetallic compounds during the solidification process of magnesium alloys using advanced micro X-ray computed tomography.By analyzing both common industrial Mg-Al-Zn alloys and a novel rare earth-containing Mg-Ni-Gd-Y alloy,we aim to characterize the nucleation,growth,and distribution of Al-Mn and eutectic intermetallics across various stages of solidification.The non destructive imaging technique employed in this research provides high-resolution,three-dimensional insights into the microstructural development,allowing for a detailed examination of the morphology,spatial arrangement,and interconnectivity of intermetallic phases.This approach overcomes limitations of traditional two-dimensional metallographic methods,offering a more comprehensive understanding of the complex three-dimensional structures formed during solidification.
文摘Background:Successful liver resection in oncologic surgery depends on safety,precision,and efficacy,all of which require a thorough understanding of liver anatomy.Contrast-enhanced computed tomography(CT)-generated three-dimensional(3D)models have been proposed as a valuable tool to enhance this understanding.However,a systematic comparison of different display modalities across professional groups has not yet been performed.Methods:In this prospective,monocentric randomized trial,we compared high-resolution twodimensional(2D)CT images of liver malignancies with their corresponding standardized,non-colored 3D virtual and printed models in facilitating anatomical and spatial understanding as well as surgical decision-making.A total of 91 participants,including 40 surgeons,10 radiologists,and 41 students,evaluated six clinical cases(three centrally and three peripherally located liver malignancies).Each participant assessed one central and one peripheral case per display modality,presented in a random order.Results:Compared to 2D CT images,both 3D virtual and printed models significantly improved the identification of tumor location(P<0.001),enhanced the comprehension of spatial relationships with adjacent liver and portal veins(P<0.001 and P=0.019,respectively),and facilitated clinical decisionmaking(P<0.001).No significant difference was observed between virtual and printed models in terms of effectiveness.Within the different groups,surgeons and students,but not radiologists,more accurately identified tumor location and spatial relationships with adjacent liver and portal veins using 3D models.Subjectively,most surgeons and students preferred 3D printed models over virtual models and 2D CT images.Conclusions:This study demonstrated that standardized,non-colored 3D virtual and printed models equally help preoperative anatomical understanding and decision-making,particularly for surgeons and students.By isolating the influence of display modality,our findings clarify prior inconsistent results and support the integration of cost-effective 3D visualization by applying virtual models into surgical planning and education.Preference for printed models despite comparable efficacy highlights the importance of user-centered implementation strategies.
文摘The original online version of this article was revised:The layout update for Article 758 has impacted the page range in the published issue,but did not affect the scholarly content.To ensure consistency with the originally assigned pages(2595-2614),we will need to publish an erratum to correct the article and restore the original page range.The original article has been corrected.
基金supported by the Canadian Institutes of Health Research(DFD-181599)the National Institutes of Health(T32AG058527)to RJB and R0190106435 to VM.
文摘Neurodegenerative disorders represent an increasingly pertinent public health crisis.As a greater proportion of the population ages,neurodegenerative disorders and other diseases of aging place undue burdens on patients,caregivers,and healthcare workers.Alzheimer’s disease(AD)and Parkinson’s disease represent the two most common neurodegenerative disorders in the population,affecting over 65 million people,worldwide.
基金supported by the National Key Research and Development Program of China(2022YFD2200501).
文摘Climate warming is significantly altering the distribution of tree species,which holds crucial implications for China’s Larix species as they are important afforestation efforts.Understanding their optimal habitats and environmental constraints is vital for predicting range shifts and guiding adaptive forest management.Previous studies prioritized changing climate impacts on horizontal range shifts of Larix,neglecting the influence of soil factors and range shift along altitudinal gradients.To address this,we applied an optimized MaxEnt model to assess current and future SSP126/SSP585 scenarios,three-dimensional habitat suitability(latitude,longitude,altitude)for four major Larix species(L.principis-rupprechtii,L.gmelinii,L.kaempferi,L.olgensis),while identifying key environmental drivers.Our results indicate that elevation and extreme moisture conditions universally constrain their distribution.Soil chemistry properties exhibited species-specific influences:cation exchange capacity critically shaped L.principis-rupprechtii and L.gmelinii ranges,whereas exchangeable aluminum determined L.kaempferi and L.olgensis distribution.Under future climate scenarios,habitat areas show divergent trajectories-L.principis-rupprechtii maximum gains 5.1%under SSP126,while L.kaempferi maximum expands 15.1%.Conversely,SSP585 triggered a 3.7% decline for L.gmelinii during the 2040s−2100s,and L.olgensis faces a net reduction to 0.4% by 2100s despite transient gains.Spatially,three species(L.kaempferi,L.gmelinii,L.olgensis)shifted northward,while L.principis-rupprechtii migrated northwest.All species distribution ascended altitudinally reflecting thermal adaptation strategies.These multidimensional insights enable targeted species selection for climate-resilient afforestation and underscore the need for soil-inclusive management planning.
基金supported by the Japan Society for the Promotion of Science(JSPS)KAKENHI(Grant Nos.JP23KK0182,JP23K26356,and JP24K00971).
文摘Stony debris flows,characterized by coarse boulders embedded in a sediment-laden matrix,greatly amplify destructive potential by altering flow dynamics and impact forces.Conventional single-phase particle-fluidmixture models often struggle to capture the complexities introduced by coarse boulders and multi-phase interactions,while strong-coupling methods can be computationally prohibitive for practical hazard assessments.In this study,we propose a semi-hybrid,fully resolved coupling numerical framework for modeling boulder-laden debris flows.This framework conceptualizes debris flows as a composite system comprising a continuous viscous fluidphase(including finesediments)and a discrete phase of arbitrarily shaped coarse particles.The continuous phase is treated as a generalized nonlinear Coulomb-viscoplastic fluidusing the smoothed particle hydrodynamics(SPH)method,while coarse particles are modeled via the distributed contact discrete element method(DCDEM).These two phases are coupled through an efficienttwo-way resolved scheme,ensuring accurate simulation of flow-boulder interactions within a unifiedtimeframe.We validate the proposed method against two physical experiments:(1)gravity-driven concrete flows and(2)debris flowinteracting with slit-type barriers.Results confirmthe method's robustness in accurately capturing fluid-solid-structureinteractions and deposition processes.Its capabilities are further showcased through the simulation of a stony debris-flowevent inWenchuan County,China,highlighting its promise for real-world engineering applications and validating the effectiveness of the existing cascade dam system in mitigating debrisflowimpact and energy dissipation.
基金supported by the National Natural Science Foundation of China(grant numbers 42171085)and the National Key R&D Program of China(Grant No.2024YFF1307801,2024YFF1307804).
文摘Integrated environmental management is important for sustainable development.Under China’s“Three Lines One Permit”(TLOP)policy,three types of management zones—priority protection,critical control,and general control zones—are established based on the ecological red line,the lower-limit line for environmental quality,and the resource use line.Human activities are regulated through a permit system.Integrated and multifactorial protection of soil,plant,hydrological,and atmospheric elements is promoted at the regional level.A follow-up assessment contributes to the improvement of policy implementation and effectiveness.This study demonstrates the achievements of the TLOP policy in Sichuan Province.Results show that(1)276 protection zones have been established under the ecological red line,covering key ecosystems and protected areas to ensure environmental security.Under the lower-limit line,1,626 functional(priority,key,and general control)zones have been designated to regulate air,water,and soil quality,enhancing environmental capacity and pollution control.(2)Through the integration and merging of the three lines,1,128 integrated management zones have been established,including 375,625,and 128 priority protection,critical control,and general control zones,respectively.Each zone has its own list of environmental permits to regulate human activities according to different environmental protection and natural resource development regimes.(3)The design of the follow-up assessment index system was informed by regional primary functions and industrial structure.The index system for provinces and cities is structured around three primary indicators—implementation updating,application,and guarantees—and 15 secondary indicators.The system for critical control zones is structured around environmental access,management,and effectiveness and 14 secondary indicators.A stringent environmental zoning system has been established through the TLOP policy,thereby safeguarding environmental security,promoting harmonious existence between humans and nature,and supporting the vision of Beautiful China.
文摘Objectives:24-h movement behaviors(24-HMB),encompassing physical activity,sedentary behavior,and sleep duration,are increasingly regarded as interrelated and important factors for mental health.However,evidence on the comprehensive association of these behaviors with mental health in adults with diabetes in developing countries remains scarce.This study examined the association between 24-HMB guidelines and psychological health among adults with diabetes in developing countries.Methods:Data were retrieved from the World Health Organization’s study on Global Aging and Adult Health Survey dataset.Adults(N=1905)diagnosed with diabetes from five low-and middle-income countries were included.The exposure of interest was adherence to 24-HMB guidelines,depression,cognition,and quality of life(QoL).Multiple logistic and multiple linear regression analyses were used to examine the association between meeting 24-HMB guidelines and depression,cognition,and QoL,respectively.Results:This cross-sectional study revealed that 28.61%complied with all three 24-HMB guidelines.Diabetic patients who met more numbers of 24-HMB guidelines had lower depression risk(OR=0.74,95%CI:0.61 to 0.91,p=0.004),greater cognition(β=0.42,95%CI:0.25 to 0.60,p<0.001),and QoL(β=1.30,95%CI:1.04 to 1.55,p<0.001)with the non-compliant population.For specific combinations,meeting all three guidelines were significantly associated with lower odds of depression,improved cognitive function,and enhanced QoL(all p<0.001).Conclusion:These findings support that meeting 24-HMB guidelines in a single or combined movement behaviors was significantly related to reduced risk of depression,enhanced cognitive function,and improved QoL among individuals with diabetes.
基金Supported by the National Natural Science Foundation of China(No.82171095)the Project of Shanghai Science and Technology(No.23XD1400500)the Research Fund of Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital(No.24QNPY049).
文摘AIM:To evaluate the differences and consistency of vault measurements obtained by Scheimpflug tomography(Pentacam),anterior segment optical coherence tomography(AS-OCT,CASIA II),and ultrasound biomicroscopy(UBM)following implantable collamer lens(ICL)V4c implantation.METHODS:Vault measurements were acquired using three modalities:Pentacam,CASIA II AS-OCT,and UBM.Repeated-measures analysis of variance was used to compare the vault values obtained by the three devices.The correlation and consistency of measurements among the three instruments were assessed using the Pearson correlation coefficient,intraclass correlation coefficient(ICC),and Bland-Altman plots.RESULTS:This retrospective study enrolled 210 myopic eyes of 210 patients(158 women and 52 men)who underwent ICL implantation:108 eyes had a myopic ICL V4c implanted,and 102 eyes had a toric ICL V4c implanted.The mean vault values measured by Pentacam,CASIA II,and UBM were 452.64±204.20μm,538.57±203.54μm,and 560.95±227.54μm,respectively,with statistically significant differences among the three groups(P<0.05).Pearson correlation analysis showed strong positive correlations between vault values measured by different instruments(all P<0.001).ICC results indicated good consistency among the three measurement modalities(all P<0.001).Stratified analysis revealed that when the vault value was≤250μm,the correlation and consistency of measurements across the three instruments were lower than those in the medium and high vault subgroups.CONCLUSION:Vault values measured by Pentacam are lower than those obtained by CASIA II and UBM,with UBM yielding the highest mean vault values.Measurements from the three instruments are not interchangeable but can serve as mutual references due to their significant correlation and good overall consistency.Pentacam and CASIA II demonstrate the highest consistency in vault measurement.Notably,when the vault value is≤250μm,the consistency between Pentacam and the other two instruments decreases significantly.
