Conectar
by Jinghui Xie, Haofang Guan, Maohui Liu, Weijun Ding
BackgroundCurrent obesity treatments include behavioral interventions, pharmacotherapy and surgery. Recently, the combination of ‘medicinal food’ products such as the plant Crataegus pinnatifida and its interaction with the gut microbiota has shown promise as an alternative therapeutic strategy to treat obesity.
MethodsWe obtained secondary metabolites (SMs) of obesity-related gut microbiota and Crataegus pinnatifida from gutMGene database and NAPSS database. bioinformatics analysis was used to elucidate key target and signaling pathways, whereas molecular docking (MD), molecular dynamics simulation and quantum chemical calculations identified crucial SMs involved in these pathways. The toxicity and physicochemical properties of these SMs were also assessed.
ResultsPhosphoinositide-3-kinase regulatory subunit 1 (PIK3R1), a key mediator in the phosphoinositide 3-kinase (PI3K)/ Protein Kinase B (Akt) pathway that is crucial for regulating insulin signaling and adipogenesis, emerged as the central hub within the PPI network. Strong binders to PIK3R1 were predicted to be quercetin, kaempferol and naringenin chalcone, suggesting their potential as therapeutic agents to treat obesity.
ConclusionThe synergistic combination of Crataegus pinnatifida and the obesity-related gut microbiota holds promise as a novel therapeutic strategy for obesity by targeting PIK3R1 and modulating the PI3K/Akt signaling pathway. Further experimental validation is necessary to confirm these findings.
by Jiaxu Chen, Lin Zhao, Jinghui Liu, Gaolei Wang, Zhan Guo
To quantitatively analyze the coupling relationships between railway safety risk factors, identify key factors contributing to railway accidents, and develop scientific strategies for accident prevention, this study introduces a complex network-based N-K model to investigate the coupling relationships of railway safety risk factors. First, we identified 18 railway safety risk factors by analyzing case data from railway accidents. The occurrence probabilities and coupling values of these risk factors were then calculated using the N-K model. Subsequently, based on the constructed railway safety risk complex network, reachability and centrality analyses were performed to determine the key factors of railway safety risk. Results indicate that the occurrence of railway accidents is directly proportional to the risk coupling value; the greater the number of coupling factors, the higher the risk value. The coupling of personnel factors and equipment factors is particularly prone to leading to railway accidents. Conversely, effective management of the coupling between personnel and equipment factors can significantly reduce the likelihood of accidents. Inadequate maintenance and unsafe human behavior were identified as critical factors contributing to railway accidents and should be prioritized in prevention efforts.
by Jingwei Song, Alexander A. Langley, Michael A. Banks, Bernarda Calla
Hemolymph is vital for bivalves, contributing to their innate immune system, nutrient transport, waste elimination, and hormone regulation. Yet, traditional sampling methods are often invasive or fatal to the organisms. In this study, we evaluated the effects of repeated, non-lethal hemolymph sampling on adult Pacific oysters (Magallana gigas). Five- year-old oysters were relaxed with magnesium sulphate, and hemolymph was extracted from half of the individuals, while the other half with relaxation served as controls. Sampling took place during gonad maturation in two groups: one laboratory conditioned (approximately three months in indoor tanks with controlled environment), and one naturally conditioned (approximately seven months at the bay in Yaquina Bay, Oregon, USA). Total mortalities ranged from 10% in the laboratory groups (after four samplings) and 22% (after seven samplings) in the natural groups; most of the mortalities took place after the last sampling. Sex ratio was similar between the sampled (66%) and control groups (63%) in the laboratory setting. In the natural setting, the final sex ratio was male biased in the group that was repeatedly sampled for hemolymph (58%) compared to the non-sampled controls (28%). Our findings highlight that repeated hemolymph sampling can be performed with minimal mortality, allowing non-lethal monitoring of hemolymph physiology over time.
by 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.
This study aimed to investigate the current status and associated factors related to theoretical competence, practical competence and attitudes towards chronic wound care among wound, ostomy and continence (WOC) nurses in China. A questionnaire survey was conducted to assess theoretical competence and attitudes, while simulations were conducted to evaluate practical competence separately. A total of 355 WOC nurses were recruited from 22 provinces, autonomous regions and municipalities across mainland China using a convenience sampling method. The study instrument was translated and adapted into a Chinese translation of the C/WoundComp instrument. A total of 351 valid questionnaires were collected, with 17 participants completing the practical competence test. The mean scores for theoretical competence, practical competence and attitude were 30.16 ± 3.84, 10.24 ± 1.44 and 23.42 ± 2.76, respectively. Multivariate linear regression analysis revealed that certification and having received post-degree wound care training within the past 2 years were the primary factors influencing WOC nurses' theoretical competence in chronic wound care. Additionally, certification and education level were the primary factors influencing WOC nurses' attitudes towards chronic wound care. Although WOC nurses demonstrated a positive attitude towards chronic wound care, their theoretical and practical competence needs improvement. This study provides evidence to inform revisions to current training content, continuing education and recertification processes for WOC nurses in China.
by Ming Li, Jingang Ma, Jing Zhao
Since Transformers have demonstrated excellent performance in the segmentation of two-dimensional medical images, recent works have also introduced them into 3D medical segmentation tasks. For example, hierarchical transformers like Swin UNETR have reintroduced several prior knowledge of convolutional networks, further enhancing the model’s volumetric segmentation ability on three-dimensional medical datasets. The effectiveness of these hybrid architecture methods is largely attributed to the large number of parameters and the large receptive fields of non-local self-attention. We believe that large-kernel volumetric depthwise convolutions can obtain large receptive fields with fewer parameters. In this paper, we propose a lightweight three-dimensional convolutional network, LKDA-Net, for efficient and accurate three-dimensional volumetric segmentation. This network adopts a large-kernel depthwise convolution attention mechanism to simulate the self-attention mechanism of Transformers. Firstly, inspired by the Swin Transformer module, we investigate different-sized large-kernel convolution attention mechanisms to obtain larger global receptive fields, and replace the MLP in the Swin Transformer with the Inverted Bottleneck with Depthwise Convolutional Augmentation to reduce channel redundancy and enhance feature expression and segmentation performance. Secondly, we propose a skip connection fusion module to achieve smooth feature fusion, enabling the decoder to effectively utilize the features of the encoder. Finally, through experimental evaluations on three public datasets, namely Synapse, BTCV and ACDC, LKDA-Net outperforms existing models of various architectures in segmentation performance and has fewer parameters. Code: https://github.com/zouyunkai/LKDA-Net.
by Jing Guo, Wenshuang Wang, Xiaoxue Zhang, Yulin Zheng, Xinran Wang
Frailty is a common multifactorial clinical syndrome in older patients that seriously affects their prognosis. However, most studies to date have ignored the dynamics of frailty. Therefore, we employed a one-month observational longitudinal study to explore frailty trajectories using a latent class growth model. In total, 155 older patients who underwent abdominal surgery involving the digestive system were assessed preoperatively, at discharge, and at the one-month follow-up, and multiple logistic regression analysis was conducted to identify factors influencing frailty trajectories. Four frailty trajectory patterns were identified: no frailty (13.5%), frailty exacerbation (40.0%), frailty improvement (20.0%), and persistent frailty (26.5%). Logistic regression analysis revealed that body mass index, the Charlson comorbidity index score, the type of surgery, the intraoperative drainage tube retention time (drainage time), the first time the patient got out of bed after surgery, the time of the first oral feed after surgery, postoperative complications, mobility, nutritional risk, and anxiety were associated with frailty trajectories. We identified four frailty trajectories in older patients undergoing abdominal surgery involving the digestive system and found that these trajectories were influenced by multiple factors. Focusing on individual specificity is conducive to accurately addressing frailty-associated clinical problems and guiding relevant nursing decisions.
by Hui Ouyang, Xiaolin Dou, Xinying Li, Mingyu Cao, Zhijing Wu, Fada Xia
PurposeThis retrospective cohort study aimed to reevaluate the prognostic impact of sex and determine whether age modifies the effect of sex on cancer-specific survival (CSS) in PTC patients.
MethodsData for PTC patients diagnosed between 2004 and 2015 were retrieved from the SEER database. The primary outcome was CSS. The effect of Sex was evaluated using both relative (hazard ratios, HRs) and absolute measures (survival differences). Additionally, the effect of sex modified by age was assessed using restricted cubic spline curves from the Cox and Poisson models, with further analysis of the interaction between sex and age.
ResultsOf 77,349 patients, 16,152 (20.9%) were male. Men exhibited older age, more aggressive clinicopathological features, and received more radioactive iodine treatment. Multivariate Cox analysis determined male sex as an independent risk factor (adjusted HR: 1.46 (1.24–1.70). The 10-year and 15-year survival differences between men and women were 0.46% (95% CI, 0.25%−0.67%) and 0.77% (95% CI, 0.31%−1.22%), respectively. Moreover, a nonlinear effect for sex across age was observed, with HRs for men plateauing below age 50 and decreasing thereafter. Importantly and conversely, before age 50, the absolute survival difference increased slightly with age, but after 50, it significantly widened. Furthermore, A significant negative multiplicative interaction between sex and age was found.
ConclusionsOur analyses provide robust evidence that male sex is indeed an independent risk factor for CSS in PTC patients. Although younger female patients show a relative survival advantage, this does not translate into a substantial absolute benefit, which widens with advancing age.
While survival rates following neonatal surgery for congenital heart disease (CHD) have improved over the years, neurodevelopmental delays are still highly prevalent in these patients. After correcting for the CHD subtype, the severity of developmental impairment is dependent on multiple factors, including intraoperative brain injury, which is more frequent and more severe in those undergoing aortic arch repair with deep hypothermic circulatory arrest (DHCA). It is proposed that brain injury may be reduced if cooling is stopped at the point of electrocerebral inactivity (ECI) on electroencephalogram (EEG), but there is limited evidence to support this as few centres perform perioperative EEG routinely. This study aims to assess the feasibility of EEG monitoring during neonatal aortic arch repair and investigate the relationship between temperature and EEG to inform the design of a future clinical trial.
Single-centre prospective observational cohort study in a UK specialist children’s hospital, aiming to recruit 74 neonates (≤4 weeks corrected age) undergoing aortic arch repair with DHCA. EEG will be acquired at least 1–3 hours before surgery, and brain activity will be monitored continuously until 24 hours following admission to intensive care. Demographic, clinical, surgical and outcome variables will be collected. Feasibility will be measured by the number of patients recruited, data collection procedures, technically successful EEG recordings and adverse events. The main outcomes are the temperature at which ECI is achieved and its duration, EEG patterns at key perioperative steps and neurodevelopmental outcomes at 24 months postsurgery.
The study was approved by the Yorkshire and The Humber Sheffield National Health Service Research Ethics Committee (20/YH/0192) on 18 June 2020. Written informed consent will be obtained from the participant’s parent/guardian prior to surgery. Findings will be disseminated to the academic community through peer-reviewed publications and presentations at conferences. Parents/guardians will be informed of the results through a newsletter in conjunction with local charities.
To develop and validate an interpretable machine learning (ML)-based frailty risk prediction model that combines real-time health data with validated scale assessments for enhanced decision-making and targeted health management in integrated medical and older adult care institutions (IMOACIs) in central China.
Mixed-methods, cross-sectional study.
13 IMOACIs across seven cities in Hunan province, central China, from 8 to 16 July 2022.
Five healthcare experts and two data scientists participated in the requirements analysis stage. A total of 586 older adults were included in the assessment data collection stage, and 15 participants (10 healthcare professionals and five data scientists) were involved in the model evaluation stage.
A collaborative requirements analysis involving healthcare professionals and data scientists guided the design of an interpretable frailty risk prediction model. Five machine learning models were developed and evaluated: logistic regression, support vector machines (SVM), random forest, extreme gradient boosting (XGBoost) and a multimodel ensemble approach. Hyperparameter optimisation was performed using stratified fivefold cross-validation with grid search, incorporating class-weighted loss functions to address class imbalance and model-specific regularisation techniques to maximise performance while preventing overfitting. To enhance interpretability, the model incorporated Shapley Additive Explanations. The final model was integrated into a user-facing platform and validated using cross-sectional standardised assessment data collected from 13 IMOACIs. A mixed-methods evaluation approach combined quantitative performance metrics with qualitative user experience assessments.
The dataset (n=586) was randomly split into training (n=468) and validation (n=118) sets (4:1 ratio). Among models, XGBoost demonstrated superior performance, achieving an accuracy of 0.89 and an area under the receiver operating characteristic curve (AUC) of 0.89 on the training set. On the validation set, the XGBoost model achieved a precision of 0.76, recall of 0.72, F1 score of 0.74, accuracy of 0.83 and AUC of 0.80, outperforming other models. User experience surveys yielded high mean ratings for satisfaction (4.20/5), perceived accuracy (4.20/5), interpretability (4.30/5) and application value (4.10/5). Qualitative analysis of user feedback identified six key themes: practical and application value, performance and data analysis, interpretability and comprehensibility, impact and integration into practice, limitations and areas for improvement, and future development and innovation prospects, highlighting the model’s strong potential for practical implementation.
This novel, interpretable ML-based frailty risk prediction model can enhance decision-making in the care of older adults by providing transparent predictions and identifying crucial factors associated with frailty. It establishes a foundation for targeted management and broader ML applications in healthcare systems, such as IMOACIs, particularly in developing regions.
by Zhihao Zheng, Jianguang Zhao, Jingjing Fan
Uav target detection is a key technology in low altitude security, disaster relief and other fields. However, in practical application scenarios, there are many complex and highly uncertain factors, such as extreme weather changes, large scale and span of the target, complex background interference, motion ambiguity, etc., which makes accurate and real-time UAV target detection still a great challenge. In order to reduce the interference of these situations in real detection scenes and improve the accuracy of UAV detection, a Global Edge Information Enhance (GEIE)module is proposed in this paper, which enables edge information to be fused into features extracted at various scales. It can improve the attention of the network to the edge information of the object. In addition, special weather conditions can greatly reduce the detection accuracy of the target, this paper proposes a Multiscale Edge Feature Enhance(MEFE) module to extract features from different scales and highlight edge information, which can improve the model’s perception of multi-scale features. Finally, we propose a Lightweight layered Shared Convolutional BN(LLSCB) Detection Head based on LSCD, so that the detection heads share the convolutional layer, and the BN is calculated independently, which improves the detection accuracy and reduces the number of parameters. A high performance YOLO detector (YOLO-GML) based on YOLO11 model is proposed. Experimental results show that Compared with YOLO11s, YOLO-GML can improve AP50 by 2.3% to 73.6% on the challenging UAV detection dataset HazyDet, achieving a better balance between accuracy and inference efficiency compared to the most advanced detection algorithms. YOLO-GML also showed good performance improvement in the SODA-A and VisDrone-2019 datasets, demonstrating the generalization of the model.
This study investigated the effects of work cessation on cognitive function among older adults in rural China. Given that cognitive disorders affect 6.04% of individuals aged 60 and above—with higher prevalence in rural areas—understanding this relationship is critical.
A cross-sectional study was employed, using data from the 2020 wave of the China Health and Retirement Longitudinal Study (CHARLS). Regression analysis assessed the impact of work cessation on cognitive function and the moderating effects of social activities, health behaviours and internet use.
Data were collected from 150 districts, 450 villages, and urban community units in China.
The study included 6,318 participants, with 4,045 currently employed and 2,273 no longer working.
Cognitive function was evaluated using measures of mathematical computation, temporal and image cognition, and situational memory was tested through 20 memory-related questions. Explanatory variables included work cessation status, while moderating variables encompassed social activities, health behaviours (smoking and alcohol consumption) and internet use.
Work cessation has a negative impact on cognitive function, particularly situational memory and overall cognitive ability. Stopping work was associated with a decrease in cognitive functioning by 0.796 SD (p
Work cessation significantly reduced cognitive function in rural Chinese older adults. Leisure activities can mitigate this decline, but they often lack quality and diversity. Health behaviour improvements show heterogeneity, and internet use mitigates cognitive decline despite urban–rural digital gaps. To protect rural older adults’ cognitive function, policies promoting flexible employment, enhanced recreational infrastructure, health outreach and bridging digital divides are proposed.
by Xi Cao, Bi-ting Zhu, Cai-peng Xie, Jing-yue Cai, Ding-guo Dong, Miao-ting Chen, Cheng-zhao Huang, Yong-chun Lin
To explore the risk factors influencing vancomycin trough concentration (Cvg−min) overexposure in critically ill patients with mechanical ventilation and rank the factors, the medical records of 194 mechanically ventilated critically ill patients hospitalized from 12/10/2021–06/10/2024 were analyzed. Among 194 critically ill patients, 77.83% were male and 22.17% were female. Univariate analysis showed that oxygenation index (OI), activated partial thromboplastin time (APTT), urea nitrogen (UN), septic shock, heart disease, congestive heart failure (CHF), moderate/severe chronic kidney disease (CKD), etc. were statistically different (P P P CI) and consistency ratio (CR) of analytic hierarchy process (AHP) was 0.0796 and 0.0885, respectively, which meets the consistency test standard. The contributions of APTT, OI, CHF and moderate to severe CKD to the overexposure of Cvg−min were 0.0584, 0.1899, 0.1614 and 0.5902, respectively. The overexposure rates of Cvg−min in patients with moderate/severe CKD and CHF were 95.12% and 95.23%, respectively. With regard to OI, when the cutoff value of OI was less than 245, the Cvg−min overexposure rate was 83%, otherwise, the overexposure rate was 60.97%. The risk factors for excessive exposure of Cvg−min in critically ill patients with mechanical ventilation were ranked as follows: moderate/severe CKD > OI > CHF > APTT.
by Chao Xu, Chuan Shao, Jing Wang, Xinmin Ding, Nan Wu
BackgroundData regarding the association between anthropometric factors and meningioma risk are inconsistent. Our aim was to investigate the association of body mass index (BMI), height, waist to hip ratio (WHR), waist circumference, and meningioma risk through a comprehensive meta-analysis.
MethodsAn extensive review of literature was conducted in PubMed and Embase databases. Random-effects models were used to pool the study-specific relative risk estimates (RRs) and 95% confidence intervals (CIs). Moreover, we employed a dose-response meta-analysis with a one-stage robust error meta-regression (REMR) model.
ResultsWe included nine prospective studies for four anthropometric factors listed above and meningioma risk. Compared with normal weight, both overweight (RR:1.11, 95% CI: 1.04, 1.19; P = 0.003, I2 = 0.0%) and obesity (RR: 1.38, 95% CI:1.16, 1.64; P 2 = 54.7%) were statistically significantly associated with meningioma risk. Dose-response analysis showed a nonlinear relationship between BMI and meningioma risk (P = 0.038). For height, a positive association was identified for men (RR:1.30, 95% CI:1.08, 1.56; P = 0.005, I2 = 0.0%) but not women (RR:1.13, 95% CI: 0.94,1.36; P = 0.186, I2 = 49.8%). Highest vs. lowest levels analyses also showed a positive association between meningioma risk and waist circumference (RR:1.89, 95% CI:1.34, 2.66; P 2 = 0.0%) and WHR (RR:1.40, 95% CI:1.00, 1.94; P = 0.048, I2 = 0.0%).
ConclusionOur meta-analysis indicates greater height (in men) and excess weight and body fat mass were associated with an increased risk of meningioma. Further prospective studies with particular attention to sex disparity and dose-response analysis are warranted to confirm our observation.
by Jinfeng Yang, Yangzi Liujiao, Xijing Zhang, Jiong Xiong, Fengming Wang, Feng Shen
BackgroundNorepinephrine (NE) is a first line and effective vasopressor for septic shock management, but its impact on newonset acute kidney injury (AKI) in those patients remains controversial. This study sought to investigate the relationship between norepinephrine dose trajectories and the new occurrence of AKI during the management of septic shock by using NE.
MethodsA retrospective cohort study was conducted using the MIMIC-IV database, which includes 3,462 patients diagnosed with septic shock during the initial 96 hours following their admission to the ICU. The unique patterns of trajectory analysis of NE were characterized by using group-based trajectory modeling (GBTM) during the initial four days of ICU admission. We employed multivariable logistic regression analysis and subgroup analysis to evaluate the association between NE dose trajectories and new-onset AKI in patients with septic shock.
ResultsThree NE dose trajectories were identified: low NE dose (47.3%), middle NE dose (41.5%), and high NE dose (11.2%). The high NE dose trajectory had significantly higher risks for new onset of AKI (OR 2.39, 95% CI 1.43–3.99), MAKE-30 (OR 3.82, 95% CI 2.97–4.91), and for 28-day mortality (HR 2.01, 95% CI 1.70–2.37) compared to the low NE dose trajectory. Despite over 90% of patients in the middle NE dose trajectory developing AKI, patients in this trajectory exhibited a lower risk of MAKE-30 and 28-day mortality. After comprehensive adjustment for demographic characteristics, comorbidities, acute physiological status, laboratory indicators, and fluid management, high NE dose trajectory remained independently associated with increased risk of new-onset AKI (OR 1.39, 95% CI 1.04–1.86, P = 0.024), this association persisted across multiple subgroup analyses.
ConclusionDuring the management of septic shock, high dose of NE trajectory was associated with high likelihood of new onset of AKI, high possibility of MAKE-30 and high 28-day mortality in patients with septic shock. High NE dose trajectory serves as an independent predictor for assessing the risk of new-onset AKI in patients with septic shock.
This study investigated alterations in the skin microclimate of the sacrococcygeal compression area in patients with malignant head and neck tumours before and after surgery. Additionally, it evaluated the effect of preventive dressings on the skin microclimate in this area and their association with intraoperative acquired pressure injuries (IAPIs), aiming to provide a foundation for preventing and reducing these injuries. Thirty patients were randomly assigned into control and two intervention groups. The sacrococcygeal skin of the control group was not protected by preventive dressing. Intervention group A was protected by silicone foam dressing, and intervention group B received a combination of liquid dressing and silicone foam dressing. Sacrococcygeal skin temperature, skin moisture levels and sebum were measured at admission, before and after surgery, and post-operative skin and pain were evaluated. There were no significant differences in skin temperature, moisture levels or sebum between the three groups before and after the intervention. The incidence of IAPI was significantly different (χ 2 = 6.240, p = 0.044). No significant difference was observed in post-operative pain incidence. Preventive dressings did not significantly alter the skin microclimate but reduced the risk of IAPIs.
by Zhenzhen Li, Lili Cui, Jing Sun, Wanlu Liu
ObjectiveThe relationship among body mass index (BMI), postoperative complications, and clinical outcomes in patients undergoing gastrectomy for gastric cancer remains unclear. This study aimed to evaluate this association using a meta-analysis.
MethodWe conducted a systematic search of the PubMed, Embase, and Cochrane Library databases up to February 25, 2024. Patients were classified into underweight (2), normal weight (18.5–25.0 kg/m2), and overweight (≥25.0 kg/m2) groups based on BMI categories. Meta-analysis was performed using a random-effects model. Additionally, exploratory sensitivity and subgroup analyses were performed.
ResultsTwenty-two studies involving 41,144 patients with gastric cancer were included for quantitative analysis. Preoperative underweight (odds ratio [OR]: 1.26; 95% confidence interval [CI]: 1.03–1.55; P = 0.024) and overweight (OR: 1.19; 95%CI: 1.09–1.30; P P P P = 0.069), whereas preoperative overweight was associated with longer disease-free survival (HR: 0.80; 95%CI: 0.70–0.91; P = 0.001). In terms of specific postoperative complications, preoperative underweight was associated with an increased risk of septic shock (OR: 3.40; 95%CI: 1.26–9.17; P = 0.015) and a reduced risk of fever (OR: 0.39; 95%CI: 0.18–0.83; P = 0.014). Preoperative overweight was associated with an increased risk of wound infections (OR: 1.78; 95%CI: 1.08–2.93; P = 0.023), intestinal fistula (OR: 5.23; 95%CI: 1.93–14.21; P = 0.001), arrhythmia (OR: 6.38; 95%CI: 1.70–24.01; P = 0.006), and pancreatic fistula (OR: 3.37; 95%CI: 1.14–9.96; P = 0.028).
ConclusionThis study revealed that both preoperative underweight and overweight status were associated with an increased risk of postoperative complications. Moreover, the postoperative survival outcomes were significantly better in overweight compared to that of underweight patients.
Trial registrationRegistration: INPLASY202480004.
by Kaifang Meng, Xu Chen, Zhishang Chen, Jing Xu
BackgroundLife expectancy at age 70 has continued to rise globally over the past 30 years. However, a comprehensive assessment of the burden of COPD in older adults is lacking. We aimed to estimate the burden of COPD and its attributable risk factors among adults aged ≥70 years.
MethodsData on the prevalence, incidence, deaths, disability-adjusted life years (DALYs), and risk factors of COPD among adults aged ≥70 years from 1990 to 2021 across 204 countries and territories, were sourced from the Global Burden of Disease Study 2021. Estimated annual percentage change (EAPC) was used to illustrate temporal trends at global and regional levels from 1990 to 2021.
ResultsIn 2021, the global numbers of prevalent and incident COPD cases among older adults were 99.7 and 7.4 million, increasing by 162.2% and 157.4% from 1990. The prevalence and incidence rates increased from 18823.5 (95% uncertainty interval (UI) 16324.4–21208.4) to 20165.6 (17703.8–22549.4) and 1429.0 (1224.2–1613.0) to 1502.7 (1309.0–1677.9) per 100,000 population (EAPC 0.31, 95% CI 0.28–0.33; 0.17, 95% CI 0.16–0.19). The global numbers of COPD-associated deaths and DALYs in 2021 reached 2.9 and 45.4 million, increasing by 70.7% and 70.0% from 2019, while the corresponding rates declined (both EAPC Conclusion
COPD in older adults has progressively become a global health challenge with rising prevalence and incidence rates. Although the death and DALY rates attributed to COPD have globally decreased in older adults, the absolute counts are rapidly increasing. The inequalities across different regions and countries underscore a multi-faceted approach to COPD management in older adults.
by Sayamon Hongjaisee, Woottichai Khamduang, Nang Kham-Kjing, Nicole Ngo-Giang-Huong, Arunrat Tangmunkongvorakul
During the COVID-19 pandemic, sex workers (SW) were one of the vulnerable groups affected by lockdown measures. COVID-19 had also disrupted HIV/Sexually transmitted infection (STI) testing and treatment services for sex workers due to numerous restrictions in specialist medical care. This study aims to assess the seroprevalence of HIV, syphilis, HBV, and HCV and associated factors among SW as COVID-19 restrictions were lifted. The SW aged over 18 years residing in Chiangmai, Thailand, were recruited between March and December 2022. An interview-based questionnaire was administered. Blood was collected for HIV, syphilis, HBV, and HCV serological testing. Logistic regression models were used to examine factors associated with these serological markers. Of 264 SW recruited, 52.3% were male. The median age was 31 years. Male sex workers (MSW) had higher seroprevalence of HIV (13% vs. 4.8%), syphilis (23.9% vs. 6.4%) and HCV (6.5% vs. 2.4%). Female sex workers (FSW) had higher seroprevalence of HBsAg (9.5% vs. 4.4%). A high proportion were unaware of their HIV/STI infection. MSW reporting receptive anal sex were more likely to be HIV and Treponema Ab positive. MSW reporting drug injection history were more likely to be HCV Ab positive. FSW reporting younger age at first sex were more likely to be HIV Ab positive. In conclusion, SW remains particularly affected by HIV/STIs. Despite the lockdown, HIV/STIs continued to spread, highlighting the need to provide access to HIV/STIs testing, prevention, and treatment services for this population, particularly young men.
by Charvi Rastogi, Xiangchen Song, Zhijing Jin, Ivan Stelmakh, Hal Daumé III, Kun Zhang, Nihar B. Shah
Many peer-review processes involve reviewers submitting their independent reviews, followed by a discussion between the reviewers of each paper. A common question among policymakers is whether the reviewers of a paper should be anonymous to each other during the discussion. We shed light on this question by conducting a randomized controlled trial at the Conference on Uncertainty in Artificial Intelligence (UAI) 2022 conference where reviewer discussions were conducted over a typed forum. We randomly split the reviewers and papers into two conditions–one with anonymous discussions and the other with non-anonymous discussions. We also conduct an anonymous survey of all reviewers to understand their experience and opinions. We compare the two conditions in terms of the amount of discussion, influence of seniority on the final decisions, politeness, reviewers’ self-reported experiences and preferences. Overall, this experiment finds small, significant differences favoring the anonymous discussion setup based on the evaluation criteria considered in this work.
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