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To investigate whether gestational diabetes mellitus (GDM) was associated with survival without bronchopulmonary dysplasia (BPD) in very preterm infants (VPIs).
Retrospective multicentre cohort study.
A total of 79 neonatal intensive care units across China, January 2019 to December 2021.
A total of 23 752 VPIs (
The primary outcomes are survival without BPD at 36 weeks’ postmenstrual age (PMA) and its components.
Infants exposed to GDM were associated with a higher rate of survival without BPD (aOR 1.12, 95% CI 1.04 to 1.21) at 36 weeks PMA and lower mortality (aOR 0.75, 95% CI 0.64 to 0.84) before 36 weeks PMA than unexposed infants. However, no significant association was observed between GDM and BPD at 36 weeks PMA (aOR 0.94, 95% CI 0.87 to 1.02), respiratory distress syndrome, need for advanced resuscitation or mechanical ventilation. After propensity score matching, GDM-exposed VPIs maintained higher survival without BPD (aOR 1.13, 95% CI 1.02 to 1.26) and lower mortality (aOR 0.81, 95% CI 0.68 to 0.97). These associations were strongest in infants born before 28 weeks (aOR 1.32, 95% CI 1.11 to 1.57) and those small for gestational age (aOR 1.41, 95% CI 1.11 to 1.80).
GDM was not associated with worsened BPD in VPIs. The positive association with survival and survival without BPD warrants could reflect a selection bias.
Post-chronic pancreatitis (CP) diabetes mellitus (PPDM-C) is a distinct form of diabetes, in which complex pathogenesis hampers adequate glycaemic control. This study aimed to identify risk factors for poor glycaemic status in PPDM-C to guide clinical management.
Cross-sectional study.
Shanghai, China.
Between January 2018 and March 2023, 1677 patients with CP were enrolled in the CP database of the National Clinical Research Center. After application of strict exclusion criteria, 302 patients diagnosed with PPDM-C were included in the study.
The primary outcome was glycaemic control. The secondary outcomes were factors that affect glycaemic control among patients with PPDM-C.
This retrospective study was conducted in patients with PPDM-C. Poor glycaemic status was defined as a glycated haemoglobin A1c level of >7% at admission. Patients were stratified into those with and without diabetes treatment. Multivariate logistic regression was performed to identify risk factors. The area under the curve (AUC) analysis was used to evaluate the predictive efficacy of these risk factors.
A total of 302 patients with PPDM-C were analysed. Poor glycaemic status was observed in 72.6% (61/84) of patients without diabetes treatment and 52.8% (115/218) of those with diabetes treatment. For those without diabetes treatment, a history of acute pancreatitis (AP) attacks (OR: 4.838, p=0.014) and smoking (1–20 pack-years, OR: 4.418; >20 pack-years, OR: 9.989; p0.001). In patients with diabetes treatment, AP attack history (OR: 5.640, p20 pack-years, OR: 11.395; p
Patients with PPDM-C in China exhibited a high prevalence of poor glycaemic status. Smoking and a history of AP attacks were significantly associated with an increased risk of poor glycaemic control. The early identification of patients with PPDM-C at elevated risk of poor glycaemic control may facilitate timely and optimised management of glycaemia.
This study was designed to explore the potential categories and their characteristics of self-compassion in Chinese enterostomy patients and then to investigate related factors.
A cross-sectional study.
The research focused on enterostomy patients who were hospitalised in two tertiary hospitals in Yangzhou City, China, between Nov 2022 and Aug 2023.
222 adult enterostomy patients in China completed the questionnaires.
This study investigated scores from the Self-Compassion Scale, Perceived Stress Scale and the Social Support Rating Scale. Information on the patients included: age, gender, marital status, monthly household income, types of medical insurance, education level, place of residence, enterostomy complications, postoperative time and whether adjuvant chemotherapy was given.
Three profiles of self-compassion in enterostomy patients were identified: ‘low self-compassion group’ (class 1), ‘moderate self-compassion group’ (class 2) and ‘high self-compassion group’ (class 3), accounting for 40.5%, 28.0% and 31.5%, respectively. The multivariate logistic analysis showed adjuvant chemotherapy, social support (PP
There is significant heterogeneity in self-compassion among enterostomy patients, and nearly half of them belong to the ‘low self-compassion group’. Focused interventions are required for females, patients with permanent enterostomy, low educational level and undergoing adjuvant radiotherapy. The self-compassion ability of patients can be effectively improved by reducing perceived stress and enhancing social support. These findings provide a basis for constructing targeted intervention strategies.
Stroke is a leading cause of death and disability worldwide, with spasticity affecting 4%–42.6% of stroke survivors. Prolonged spasticity can lead to pain, restricted joint mobility and muscle weakness. Current non-pharmacological treatments include physical therapy, orthoses and surgery. Muscle energy techniques (METs) and blood flow restriction training (BFRT) have shown promise in improving muscle function and reducing spasticity. This study aims to investigate the combined effect of MET and BFRT on upper limb motor function in patients with poststroke spasticity.
This study is a single-blind randomised controlled trial involving patients with poststroke spasticity. Participants will be randomly assigned to either the MET+BFRT group or the passive stretching group. Both groups will receive conventional rehabilitation therapy, with additional MET+BFRT or passive stretching interventions. The intervention will last for 6 weeks, with four sessions per week. Primary outcomes include the simplified Fugl-Meyer assessment (FMA) and surface electromyography, while secondary outcomes include the Modified Barthel Index and the Modified Ashworth Scale.
Based on literature data, patients who had a stroke have an average baseline upper limb FMA score of 40 points. Conventional rehabilitation typically improves FMA to 46 points (SD=8). This trial expects an additional 6-point improvement from the intervention. With α=0.05 (two-sided), 90% power (1–β=0.90) and 10% dropout rate, PASS V.11.0 calculation indicates a minimum requirement of 42 participants per group.
Statistical analysis will be conducted using IBM SPSS Statistics V.25. Intention-to-treat analysis will be used to analyse the result, which means the last observation will be used for interpolation when data are missing. Continuous variables will be summarised as mean±SD for normally distributed data or as median and IQRs for non-normally distributed data. Categorical variables will be presented as frequencies and percentages. For continuous variables that meet the criteria of normal distribution and homogeneity of variance, two-way analysis of variance with repeated measures will be applied; for those that do not meet these criteria, the Mann-Whitney U test will be used. Categorical variables will be analysed with the 2 test or Fisher’s exact test.
The study protocol has been approved by the ethics committee of Jiaxing Hospital of Traditional Chinese Medicine (2024-016). Participants will provide written informed consent before inclusion. The results will be disseminated through peer-reviewed journals and conference presentations.
ChiCTR2400085996.
by Hongfei Liu, Wenli Li, Gaoqiang Fan, Qiaoyi Chen, Shulei Zhang, Beibei Zhang
This study aimed to investigate the effects of dietary chitosan oligosaccharide (COS) supplementation on growth performance, antioxidant capacity, immune function, duodenal digestive enzyme activity, and jejunal morphology in growing female minks. Ninety-six 12-week-old minks were randomly assigned to six groups (0, 100, 200, 300, 400, or 500 mg/kg COS), with 8 replicates per treatment and 2 minks per replicate, for an 8-week trial. The results showed that average daily gain (ADG) increased quadratically with increasing COS levels (P P P P P Pby Mengqi Yuan, Yajing Yuan, Xiangqun Zhang, Zhenghao Zhu, Chenxi Zhao, Xiangqian Gao, Genyuan Du
Millimeter-wave (mmWave) radar has become an important research direction in the field of object detection because of its characteristics of all-time, low cost, strong privacy and not affected by harsh weather conditions. Therefore, the research on millimeter wave radar object detection is of great practical significance for applications in the field of intelligent security and transportation. However, in the multi-target detection scene, millimeter wave radar still faces some problems, such as unable to effectively distinguish multiple objects and poor performance of detection algorithm. Focusing on the above problems, a new target detection and classification framework of S2DB-mmWave YOLOv8n, based on deep learning, is proposed to realize more accuracy. There are three main improvements. First, a novel backbone network was designed by incorporating new convolutional layers and the Simplified Spatial Pyramid Pooling - Fast (SimSPPF) module to strengthen feature extraction. Second, a dynamic up-sampling technique was introduced to improve the model’s ability to recover fine details. Finally, a bidirectional feature pyramid network (BiFPN) was integrated to optimize feature fusion, leveraging a bidirectional information transfer mechanism and an adaptive feature selection strategy. A publicly available 5-class object mmWave radar heatmap dataset, including 2,500 annotated images, were selected for data modeling and method evaluation. The results show that the mean average precision (mAP), precision and recall of the S2DB-mmWave YOLOv8n model were 93.1% mAP@0.5, 55.8% mAP@0.5:0.95, 89.4% and 90.6%, respectively, which is 3.3, 1.6, 4.5 and 7.7 percentage points higher than the baseline YOLOv8n network without increasing the parameter count.The objective of this study was to identify risk factors for enema reduction failure and to establish a combined model that integrates deep learning (DL) features and clinical features for predicting surgical intervention in intussusception in children younger than 8 months of age.
A retrospective study with a prospective validation cohort of intussusception.
The retrospective data were collected from two hospitals in south east China between January 2017 and December 2022. The prospective data were collected between January 2023 and July 2024.
A total of 415 intussusception cases in patients younger than 8 months were included in the study.
280 cases collected from Centre 1 were randomly divided into two groups at a 7:3 ratio: the training cohort (n=196) and the internal validation cohort (n=84). 85 cases collected from Centre 2 were designed as external validation cohort. Pretrained DL networks were used to extract deep transfer learning features, with least absolute shrinkage and selection operator regression selecting the non-zero coefficient features. The clinical features were screened by univariate and multivariate logistic regression analyses. We constructed a combined model that integrated the selected two types of features, along with individual clinical and DL models for comparison. Additionally, the combined model was validated in a prospective cohort (n=50) collected from Centre 1.
In the internal and external validation cohorts, the combined model (area under curve (AUC): 0.911 and 0.871, respectively) demonstrated better performance for predicting surgical intervention in intussusception in children younger than 8 months of age than the clinical model (AUC: 0.776 and 0.740, respectively) and the DL model (AUC: 0.828 and 0.793, respectively). In the prospective validation cohort, the combined model also demonstrated impressive performance with an AUC of 0.890.
The combined model, integrating DL and clinical features, demonstrated stable predictive accuracy, suggesting its potential for improving clinical therapeutic strategies for intussusception.
Sepsis is a major cause of death both globally and in the United States. Early identification and treatment of sepsis are crucial for improving patient outcomes. International guidelines recommend hospital sepsis screening programmes, which are commonly implemented in the electronic health record (EHR) as an interruptive sepsis screening alert based on systemic inflammatory response syndrome (SIRS) criteria. Despite widespread use, it is unknown whether these sepsis screening and alert tools improve the delivery of high-quality sepsis care.
The Sepsis Electronic Prompting for Timely Intervention and Care (SEPTIC) master protocol will study two distinct populations in separate trials: emergency department (ED) patients (SEPTIC-ED) and inpatients (SEPTIC-IP). The SEPTIC trials are pragmatic, multicentre, blinded, randomised controlled trials, with equal allocation to compare four SIRS-based sepsis screening alert groups: no alerts (control), nurse alerts only, prescribing clinician alerts only, or nurse and prescribing clinician alerts. Randomisation will be at the patient level. SEPTIC will be performed at eight acute-care hospitals in the greater New York City area and enrol patients at least 18 years old. The primary outcome is the percentage of patients with completion of a modified Surviving Sepsis Campaign (SSC) hour-1 bundle within 3 hours of the first SIRS alert. Secondary outcomes include time from first alert to completion of a modified SSC hour-1 bundle, time from first alert to individual bundle component order and completion, intensive care unit (ICU) transfer, hospital discharge disposition, inpatient mortality at 90 days, positive blood cultures (bacteraemia), adverse antibiotic events, sepsis diagnoses and septic shock diagnoses.
Ethics approval was obtained from the Columbia University Institutional Review Board (IRB) serving as a single IRB. Results will be disseminated in peer-reviewed journal(s), scientific meeting(s) and via social media.
ClinicalTrials.gov: NCT06117605 and
Epidemiological evidence regarding the impact of elite athletic careers on cognitive trajectories remains contentious. Although consistent physical activity has been associated with long-term brain health, former elite athletes appear to represent a unique population. While past research has established a connection between sport-related concussions (SRCs) and later cognitive decline, less attention has been given to the cognitive function of former athletes who have not experienced SRCs. Therefore, well-structured cross-sectional studies accounting for established dementia risk factors are needed to compare mild cognitive impairment (MCI) prevalence between former elite athletes and the general population.
This cross-sectional study will be conducted at Beijing Sport University (BSU) in Beijing, China. It is designed as a comparative study, aiming to recruit a sample of around 360 participants aged 65 and above. This sample will comprise 180 former elite athletes without a history of SRCs recruited via the BSU Retirement Welfare Office (the former athlete group), and 180 age-matched individuals from the communities in three districts in Beijing (the comparison group). Participants will complete a comprehensive questionnaire covering sociodemographic information, dementia-related risk factors, current physical activity levels and, for the former athlete group specifically, details of their athletic careers. MCI and instrumental activities of daily living will be assessed using the Montreal Cognitive Assessment, Memtrax continuous recognition test and Lawton Instrumental Activities of Daily Living (IADL) scale. The primary objective is to determine whether former elite athletes without a history of SRCs have a lower MCI prevalence than the general population. The secondary objective is to assess if these former elite athletes have a reduced prevalence of amnestic MCI and impairment in IADL compared with the general population. Additionally, the study aims to explore whether specific career-related characteristics of former athletes, such as the type of sport and contact exposure, are correlated with their cognitive function and IADL abilities in later life as a secondary exploratory component. The study will calculate the crude prevalence ratios (PRs) and adjusted prevalence ratios (aPRs) with 95% CIs using the modified Poisson regression model with robust error variance.
Ethical approval was obtained from the Ethics Committee/Internal Review Board of BSU (approval number: 2024042H). All procedures will adhere to the Helsinki Declaration. The study’s findings will be provided to participants as deemed appropriate. The outcomes will be communicated through abstract presentations at national or international conferences/academic seminars, as well as through publication in a peer-reviewed journal.
ChiCTR2400085800.
by Lijun Jiang, Qian Yu, Hui Li, Fudong Wang, Feng Liu, Zhenxing Xu
ObjectiveTo determine the association between blood pressure variability (BPV), coagulation indexes, and germinal matrix-intraventricular hemorrhage (GMH-IVH) in preterm infants with gestational age ≤ 32 weeks. In addition, we aimed to determine whether the combination can predict the occurrence and outcome of GMH-IVH.
MethodsThis retrospective study included 106 preterm infants. According to the presence of GMH-IVH, the preterm infants were divided into GMH-IVH (51 patients) and no GMH-IVH (55 patients) groups. Furthermore, according to the short-term prognoses, the GMH-IVH group was subdivided into good outcome (30 patients) and poor outcome (21 patients) groups. Coagulation function and BPV indexes were collected at admission. Univariate analysis, logistic regression model, and receiver operating characteristic curve were used to analyze the relationship between indexes and the occurrence and outcome of GMH-IVH in preterm infants.
ResultsUnivariate analysis showed that the difference between maximum and minimum (Max-Min); standard deviation (SD); coefficient of variation (CV) of BPV, prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), and proportion of premature rupture of membranes (PROM) were higher in the GMH-IVH group than the no GMH-IVH group (P ). Logistic regression analysis showed that INR and DBP SD were directly correlated with GMH-IVH, and the joint curve had the largest area under the curve (AUC) (82.4% sensitivity and 79.7% specificity). BPV SD, BPV CV, APTT, and INR were higher in the poor outcome group than in the good outcome group (P ). Logistic regression analysis showed that INR and DBP SD were directly correlated with poor outcomes in preterm infants with GMH-IVH. The joint curve had the largest AUC (sensitivity 76.2% and specificity 90.0%).
ConclusionIncreased INR and DBP SD are directly associated factors for the developement and poor short-term outcome of GMH-IVH, and combined monitoring of INR and DBP SD has certain reference value for the early identification and prognosis evaluation of GMH-IVH in preterm infants with gestational age ≤ 32 weeks.
by Xiaowei Chi, Yi Xu, Qiang Li, Keshu Xia, Qiang Fu
BackgroundThe selection of safe and effective anesthetic agents for patients undergoing bariatric surgery is vital. This study aimed to evaluate the efficacy and safety of ciprofol in inducing general anesthesia in patients with obesity undergoing laparoscopic sleeve gastrectomy.
MethodsA total of 212 patients scheduled for laparoscopic sleeve gastrectomy were randomly allocated into two groups in a 1:1 ratio: the ciprofol (0.5 mg/kg, n = 106) and propofol (2.5 mg/kg, n = 106) groups. The primary endpoint was to assess the success rate of anesthesia induction. Secondary endpoints included evaluating the time of induction, loss of eyelash reflex, changes in bispectral index, and adverse event incidence.
ResultsThe success rates of anesthesia induction were 100% in both groups. Ciprofol demonstrated non-inferiority to propofol in induction success. The times to successful induction onset and eyelash reflex disappearance were significantly longer in the ciprofol group compared to those in the propofol group (39.38 ± 8.57 s vs. 36.74 ± 6.82 s, P = 0.014 and 40.36 ± 8.59 s vs. 37.77 ± 6.84 s, P = 0.016, respectively). The adverse events incidence was significantly lower in the ciprofol group compared to that in the propofol group (25.47% vs. 89.62%, P = 0.000). The number of patients requiring top-up doses was not statistically significant (3.77% vs. 7.55%, P = 0.235). Ciprofol demonstrated advantages in hemodynamic stability and maintaining a better sedation level post-induction. Ciprofol was associated with a significantly lower incidence of hypotension compared to propofol (14.15% vs. 37.74%, P Conclusion
Ciprofol offers a better sedative effect, fewer adverse events, and greater hemodynamic stability during general anesthesia induction in patients with obesity undergoing laparoscopic sleeve gastrectomy.
Trial registrationClinicalTrials.gov NCT05522998
by Qian Liu, Yuanhao Peng, Wenbin Liu, Xiangjian Luo
Cervical cancer remains the second leading cause of female cancer mortality worldwide, with metastasis representing a critical therapeutic challenge. This study systematically reveals the key role of SERPINH1 (Serpin Family H Member 1) as a hub regulator of malignant progression in cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC). Through analysis of TCGA-CESC datasets, we identified that high SERPINH1 expression is significantly correlated with poor prognosis and contributes to tumor progression by promoting cell proliferation, invasion, and metastatic phenotypes. In vitro experiments validated these findings, demonstrating that SERPINH1 overexpression markedly enhanced the proliferation, invasion, and metastasis of cervical cancer cells, whereas its knockdown substantially inhibited these processes. Furthermore, based on the SERPINH1-related differentially expressed genes, a prognostic risk model was constructed, successfully identifying PLOD1, ITGA5, and ESM1 as core collaborative genes affecting patient prognosis. Overall, our findings underscore the multiple functions of SERPINH1 as a hub for cervical cancer metastasis regulation, suggesting its potential as a promising biomarker for tailoring strategies in metastasis patients of CESC.Infective endocarditis (IE) is a global public health challenge, and our understanding of its temporal evolution in China compared with the Group of Twenty (G20) countries remains limited. This study aims to analyse the disease burden of IE in China from 1990 to 2021, forecast trends for the next 15 years and compare the findings with those in G20 countries.
Observational study.
The data of 20 countries and regions in G20 were obtained from the Global Burden of Disease (GBD) Study 2021.
Data were publicly available and individuals were not involved.
Using data from the GBD 2021, we collected incidence, disability-adjusted life-years (DALYs) and age-standardised rates for both China and G20 countries. Temporal trends were assessed using the estimated annual percentage change (EAPC) and a joinpoint regression analysis was conducted to pinpoint periods of significant change. Additionally, a decomposition analysis was performed to identify the factors driving changes. Finally, the Bayesian age-period-cohort model was used to forecast trends for the next 15 years.
In 2021, there were 264 282 (95% UI: 216 083 to 315 405) incident cases of IE in China, resulting in 49 925 (95% UI: 38 779 to 69 119) DALYs. The age-standardised incidence rate (ASIR) and age-standardised DALY rate (ASDR) were 14.38 (95% UI: 12.03 to 16.92) and 3.46 (95% UI: 2.65 to 5.01) per 100 000 population, respectively, with both rates being higher in males than in females. Notably, both ASIR and ASDR showed a pattern of first decreasing and then increasing with age, with the highest values observed in the age group of 95 years and above. From 1990 to 2021, the ASIR of IE in China showed a slow upward trend (EAPC: 0.49, 95% CI: 0.44 to 0.55), which was lower than the average level among G20 countries. In contrast, the ASDR exhibited a significant downward trend (EAPC: –6.26, 95% CI: –6.8 to –5.71), representing the largest decline among the G20 countries. The most notable increase in ASIR occurred from 1995 to 2005 in both China and the G20. The greatest decrease in ASDR was observed in China between 2001 and 2004 and in the G20 between 2018 and 2021. Projections suggest that over the next 15 years, the ASIR for both males and females in China will continue to rise, while the ASDR will show a declining trend.
In China, the incidence of IE-related diseases has steadily increased across both genders, despite a declining trend in DALYs. Compared with G20 countries, China’s age-standardised burden of IE is relatively low, yet the large increasing number of cases should not be underestimated. Therefore, establishing effective prevention and treatment strategies is crucial to alleviating the future burden of IE.
by Qianhui Wang, Pengyu Hu, Haibo Cong
BackgroundSerum anion gap has diagnostic value in patients with multiple myeloma, but its association with ICU mortality and threshold value remain unclear.
MethodsMultiple myeloma patients meeting criteria were selected from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The exposure factor was serum anion gap, and the outcome was ICU in-hospital mortality. Multivariable-adjusted Cox regression, curve fitting, and forest plots were used to evaluate the relationship between anion gap and ICU mortality in multiple myeloma patients.
ResultsA total of 323 eligible subjects were included (206 males [63.8%], 117 females [36.2%]). Multivariable Cox regression showed that each 1-unit increase in AG was associated with a 7% increased mortality risk (HR = 1.07, 95%CI = 1.01–1.14, P = 0.032). Curve fitting revealed a nonlinear relationship between anion gap and ICU mortality (nonlinear P = 0.038), with the lowest risk at 15.29 mmol/L. Incorporating AG into traditional risk factor models improved mortality prediction (P = 0.038).
ConclusionSerum anion gap exhibits a nonlinear relationship with ICU mortality in multiple myeloma patients, with the lowest risk observed at approximately 15.29 mmol/L.
by Shuangyan Tu, Menglin Jiang, Rong Yang, Zhiqiang Deng, Cairong Zhu, Muke Zhou, Zhangyan Peng, Lihong Zhao
PurposeTo identify the scale that is more suitable for oral health assessment in stroke patient population with indwelling gastric tubes.
MethodsA total of 198 patients with indent gastric tubes were selected from 1250 stroke patients to evaluate their oral health using both the BOAS and the OHAT scales. The scores obtained from both scales were then compared to evaluate the feasibility, reliability, and validity of each scale in assessing oral health among stroke patients with indwelling gastric tubes.
ResultsThe results showed that both the BOAS and OHAT scales exhibited good reliability and validity in stroke patients with indwelling gastric tubes. The Cronbach’s alpha coefficients of BOAS and OHAT in stroke patients with indwelling gastric tubes were 0.89 and 0.91, respectively. In the exploratory factor analysis, one and two common factors were extracted from the two scales, with cumulative variance contributions of 65.89% and 71.85%, respectively. In addition, potential influencing factor correlation analysis found that gender and marital status had a significant correlation with the BOAS score(P Conclusions
The BOAS and OHAT have demonstrated good reliability and validity and in their ability to assess the oral health of stroke patients with indwelling gastric tubes. Therefore, it is recommended that the selection of oral assessment scales should be further refined in different disease stages of stroke patients to assess the oral health status of patients more accurately and personalized.
by Qiong Zhou, Liwen Qian, Chong Shen, Xinyan Bei, Gaojie Liu, Xiaonan Sun
PurposeThis study aims to develop a fully automated VMAT planning program for short-course radiotherapy (SCRT) in Locally Advanced Rectal Cancer (LARC) and assess its plan quality, feasibility, and efficiency.
Materials and methodsThirty LARC patients who underwent short-course VMAT treatment were retrospectively selected from our institution for this study. An auto-planning program for neoadjuvant short-course radiotherapy (SCRT) in LARC was developed using the RayStation scripting platform integrated with the Python environment. The patients were re-planned using this auto-planning program. Subsequently, the differences between the automatic plans (APs) and existing manual plans (MPs) were compared in terms of plan quality, monitor units (MU), plan complexity, and other dosimetric parameters. Plan quality assurance (QA) was performed using the ArcCHECK dosimetric verification system.
ResultsCompared to MPs, the APs achieved similar target coverage and conformity, while providing more rapid dose fall-off. Except for the V5Gy dose level, other dosimetric metrics (V25 Gy, V23 Gy, V15 Gy, Dmean, etc.) for the small bowel were significantly lower in the AP compared to the MP (p Conclusion
We developed a fully automated, feasible SCRT VMAT planning program for LARC. This program significantly enhanced plan quality and efficiency while substantially reducing the dose to OARs.
by Yu-Peng Ye, Guo-You Qin, Xinyu Zhang, Shan-Shan Han, Bo Li, Ning Zhou, Qi Liu, Chen-xi Li, Yang-Sheng Zhang, Qian-qian Shao
ObjectiveThis study aims to explore the impact of physical exercise on university students’ life satisfaction and analyses the chain mediation effect of general self-efficacy and health literacy, providing empirical reference and theoretical foundation for the comprehensive enhancement and optimization of students’ mental health.
MethodBased on data from the “China University Student Physical Activity and Health Tracking Survey” (CPAHLS-CS) 2024, the measurement scales used included the Physical Activity Rating Scale (PARS-3), the Satisfaction with Life Scale (SWLS), the General Self-Efficacy Scale (GSES), and the 9-item Short Form Health Literacy Scale (HLS-SF9). A total of 4575 valid samples were analyzed.
ResultsA significant positive correlation was found between physical exercise and life satisfaction (r = 0.137, P Conclusion
University students’ life satisfaction is closely related to physical exercise, general self-efficacy, and health literacy. General self-efficacy and health literacy play a full mediating role in the effect of physical exercise on life satisfaction.
by Qianli Huang, Changhui Shao, Wei Wei, Shan Ou
BackgroundLidocaine is increasingly used for surgical patients requiring general anesthesia. However, its clinical benefits on postoperative recovery quality are not well established. Our main objective aims to summarize the evidence regarding the effectiveness of perioperative lidocaine infusion on postoperative subjective quality of recovery (QoR).
Methods and analysisThis protocol will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guideline. This systematic review will include randomized controlled trials (RCTs) from their inception until December 31st, 2024 with no language restrictions. The major databases including PubMed, Embase, and the Cochrane library will be comprehensively searched and supplemented by a hand searching reference lists of all included articles. Searches will involve studies assessing the efficacy of the perioperative lidocaine infusion for improving postoperative QoR, in comparison to placebo, or on treatment. The two authors will independently screen studies, extract study data and assess bias risk of the studies. The subjective QoR (QoR-15, QoR-40) on postoperative day 1–3 will be defined as primary outcome, whereas secondary outcomes will include morphine consumption, incidence of postoperative nausea and vomiting, time to first bowel movement, time to first flatus, and length of hospital stay. A meta-analysis will be performed using Review Manager 5.3 software. Sensitivity analyses, subgroup analysis and publication bias will also be conducted. The evidence quality of pooled results will be assessed by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.
DiscussionThis review and meta-analysis is anticipated to provide the evidence for the role of intravenous lidocaine on the subjective quality of recovery after surgery. In addition, the findings from this review will help clinicians with developing effective and safe perioperative anesthetic management regimens for surgery patients.
Study registrationPROSPERO registration number: CRD42024585866
by Zhikai Su, Zhenjie Ling, Haoqiang Chen, Lei Hu, Songtao Xiang, Qian Li, Jianfu Zhou
ObjectiveEvidence suggests that nephrolithiasis and hyperlipidemia are linked. The study is designed to identify diagnostic biomarkers for nephrolithiasis in conjunction with hyperlipidemia using bioinformatics analysis, while exploring the potential common denominator pathogenesis.
MethodsThe NCBI Gene Expression Omnibus (GEO) database provided separate datasets for nephrolithiasis and hyperlipidemia. We employed the R limma package to detect differentially expressed genes (DEGs), which were subsequently analyzed for enrichment using Gene Set Enrichment Analysis (GSEA), Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. Immune cell infiltration was analyzed by the CIBERSORT method. The WGCNA-R package clustered genes with similar expression profiles, followed by an analysis of the associations between the modules and specific traits or phenotypes. The STRING database was utilized to establish a protein-protein interaction (PPI) network and key functional modules, which were then analyzed using Cytoscape software. Diagnostic genes for both diseases were screened from core hub genes using least absolute shrinkage and selection operator (Lasso) regression. Subsequently, we generated receiver operating characteristic (ROC) curves to validate the predictive ability of these diagnostic genes for diagnosing nephrolithiasis in combination with hyperlipidemia. Lastly, the Network Analyst platform facilitated the construction of transcription factor-gene (TF-gene) and TF-miRNA regulatory networks.
ResultsBased on datasets of nephrolithiasis and hyperlipidemia, we identified 167 DEGs and 74 hub genes through WGCNA. Using PPI networks and machine learning techniques, we recognized three frequently diagnostic genes (HSP90AB1, HSPA5, and STUB1), which demonstrated high diagnostic validity. The functional enrichment of these three diagnostic genes primarily involved pathways related to cellular metabolism.
ConclusionsOur study identified three candidate diagnostic genes that can predict nephrolithiasis in conjunction with hyperlipidemia, providing a solid foundation for further exploration into the pathogenesis of nephrolithiasis and hyperlipidemia.
FreshRSS 